2018 Fl Smmc Healthtrack Choice Tools Quiz

20 Questions | Total Attempts: 164

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2018 Fl Smmc Healthtrack Choice Tools Quiz

HealthTrack Choice Tools Quiz


Questions and Answers
  • 1. 
    James is wanting to find a Pediatric doctor for his child. Which Search field would you look under to find a Pediatric doctor?
    • A. 

      • Address

    • B. 

      • Gender

    • C. 

      • Panel Status

    • D. 

      • Specialty

  • 2. 
    Which option would you select to enroll into a medical plan?
    • A. 

      • LTC Enrollment

    • B. 

      • Log Contact

    • C. 

      • MMA Enrollment

    • D. 

      • New Task

  • 3. 
    Can an OB/GYN doctor be a PCP?
    • A. 

      • No, Never

    • B. 

      • Yes, as long as the enrollee states they see them for Primary care needs as well.

    • C. 

      • Yes, as long as they are listed as a PCP.

    • D. 

      • Yes, they are a doctor.

  • 4. 
    To change the LTC Direct Service Provider, the enrollee should call:
    • A. 

      • DOEA

    • B. 

      • DCF

    • C. 

      • Care Coordinator

    • D. 

      • SSA

  • 5. 
    Can you search for a PCP using a zip code?
    • A. 

      • Yes, only in certain areas.

    • B. 

      • No, you can only use an exact address.

    • C. 

      • Yes, if you type in a zip code and choose a mile radius, it will populate the PCP's in that area.

    • D. 

      • No, it would pull up too many PCP's in that area.

  • 6. 
    What plans can this enrollee enroll into?
    • A. 

      •A. United Healthcare of Florida

    • B. 

      •B. Amerigroup Community Care

    • C. 

      •C. Sunshine Health

    • D. 

      •D. A and C

  • 7. 
    Which of the following plans does Dr. James Joyner accept?
    • A. 

      • Simply Healthcare

    • B. 

      • Humana

    • C. 

      • Sunshine Health

    • D. 

      • Amerigroup

  • 8. 
    Which search tool options can you use for MMA?
    • A. 

      • PCP Search only

    • B. 

      • Specialist Search only

    • C. 

      • Hospital Search only

    • D. 

      • You can search with Hospital, Specialist, and/or PCP.

  • 9. 
    If an enrollee is ready to enroll and requests a PCP, but you are unable to locate the doctor in Health Track, you should...
    • A. 

      • Tell the enrollee to call the doctor to confirm the plans they accept. If they have already received confirmation from the PCP, advise the enrollee that they may enroll without selecting a PCP. Inform them that they will have to contact the plan once it becomes effective to add the PCP or the plan will select one for them.

    • B. 

      • Tell the enrollee that they can enroll without selecting a PCP and see any doctor that takes Medicaid. Because it really doesn't matter, you can select the first provider that populates under the plan that they requested in Health Track.

    • C. 

      • Advise the enrollee that you will hold on while they look on the providers website to verify if it provides a list of plans they accept, even if they previously informed you that they do not have access to the internet.

    • D. 

      • Advise the enrollee that the doctor must not accept Medicaid because they didn't pull up in the system at all and they must provide you with the name, address and/or telephone number of another doctor in order to enroll into a MMA plan.

  • 10. 
    "My grandfather has Crohn's Disease and he has to be very careful about what he eats.  His stomach is very sensitive to a lot of foods.  I take care of him, but I'm not sure what type of food is right for him.  I don't want his condition to worsen because I'm not giving him the right foods." Which covered service is the caller referring to?
    • A. 

      • Home Delivered Meals

    • B. 

      • Hospice

    • C. 

      • Personal Care

    • D. 

      • Nutritional Assessment/Risk Reduction Services

  • 11. 
    Ms. Jones has used Meals on Wheels in the past for LTC.  She would like to continue using Meals on Wheels.  How should you proceed?
    • A. 

      • Search for Meals on Wheels and tell the caller which LTC plans they accept. Inform the caller that you cannot assign Meals on Wheels, but a Care Coordinator from the plan will help assign the providers once the plan is effective.

    • B. 

      • Search for Meals on Wheels and tell the caller which LTC plans they accept. Assign Meals on Wheels to the plan enrollment. Tell the caller she will receive this service when the plan starts.

    • C. 

      • Search for Meals on Wheels and tell the caller which LTC plans they accept. Tell the caller she will need to call Meals on Wheels directly for delivery and menu information.

    • D. 

      • Tell the caller she will receive a list of providers from the plan once it becomes effective. She should call DOEA to find out if Meals on Wheels works with LTC plans.

  • 12. 
    If the caller does not have a PCP you should:
    • A. 

      • Offer to search for a PCP in the area, ask for preferences such as male or female, a language preference, etc.

    • B. 

      • Tell the caller to research the doctors in the area and call us back.

    • C. 

      • Tell the caller the plan will send a list of doctors when the plan becomes effective.

    • D. 

      • Provide the caller the plan website so they can get a full list of providers.

  • 13. 
    When will the enrollee receive the health plan ID card and membership information from the plan?
    • A. 

      • As soon as the enrollee enrolls with the plan.

    • B. 

      • After the enrollment becomes effective.

    • C. 

      • During open enrollment.

    • D. 

      • 7-10 business days after the enrollment is completed.

  • 14. 
    Daniel Bannerman calls to enroll into Simply HealthCare. He states that he just moved from another state and does not have a Primary Care Provider. How do you proceed?
    • A. 

      • Inform Mr. Bannerman that in order to complete the enrollment, he is required to choose a Primary care Provider under the plan's network.

    • B. 

      • Inform Mr. Bannerman that he really doesn't need a primary care provider and that he can choose one whenever he wants to.

    • C. 

      • Inform Mr. Bannerman that you can help him find a PCP in the area and he is not required to choose a PCP at this time. If he does not choose one then the plan will assign a PCP.

    • D. 

      • Inform Mr. Bannerman that the plan will choose a doctor that doesn't have a lot of patients for him.

  • 15. 
    The caller is currently enrolled into a plan. The caller states that they are happy with the plan and do not want to process a plan change, but they need to change the PCP.  How do you proceed?
    • A. 

      • Tell the caller the doctor can only be changed during the 120 days.

    • B. 

      • Refer to the Medicaid Helpline to change the doctor.

    • C. 

      • Tell the caller to call the health plan to change the doctor.

    • D. 

      • Change the doctor through HealthTrack.

  • 16. 
    Mrs. Osborne calls to enroll into Humana with Dr. Imani Akindo. You search for the provider, but she does not show up in HealthTrack. Mrs. Osborne states that she just talked to the provider and was told that they accept Humana.  How do you proceed?
    • A. 

      • Inform Mrs. Osborne that this is the most up-to-date information that we have received from the plan and that she can call the plan to add Dr. Imani Akindo once the plan become effective.

    • B. 

      • Advise Mrs. Osborne that Dr. Imani Akindo did not show under Humana and apparently no longer accepts Humana any more.

    • C. 

      • Inform Mrs. Osborne that this is the most up-to-date information that we have received from the plan and that Dr. Imani Akindo is not on the list and another provider will need to be selected.

    • D. 

      • Advise Mrs. Osborne that Dr. Imani Akindo accepts all of the plans available in her region, but she will have to call the plan to add her as the PCP.

  • 17. 
    Anita calls to enroll herself and her daughter in a plan. She wants to choose Prestige with her own PCP and states that her daughter's Pediatrician only accepts Staywell. Anita wants to know if she must choose the same plan for both of them because they are on the same case. What should you inform Anita?
    • A. 

      • Yes, because the babies have to enroll in the same plan that the mother has.

    • B. 

      • Yes, because it's better for everyone to have the same plan and family doctor.

    • C. 

      • Yes, because AHCA requires that one plan and PCP per family for billing purposes.

    • D. 

      • No, she can choose a different plan and PCP for each enrollee.

  • 18. 
    "My aunt is on a lot of medications for her liver disease.  She has a new medication that makes her throw up every time she takes it.  She usually gets blood drawn every month to check her levels, but that has not happened in over 6 months. I don't think her medicine is right." Which covered service is the caller referring to?
    • A. 

      • Medical Equipment and Supplies

    • B. 

      • Medication Administration

    • C. 

      • Caregiver Training

    • D. 

      • Medication Management

  • 19. 
    What do the numbers in the boxes indicate?
    • A. 

      • How many of each kind of provider are available through the plan.

    • B. 

      • The number of enrollees that type of provider will accept.

    • C. 

      • The provider rating for the plan.

    • D. 

      • The saved provider selection based off the search results.

  • 20. 
    Which of the following services does this direct service provider cover?
    • A. 

      • Adult Daycare

    • B. 

      •B. Medication Administration

    • C. 

      •C. Attendant Care

    • D. 

      •D. Both B and C

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