2018 Fl Smmc Verification Quiz

If the case worker does not have the PIN, the agent should document the name, agency, title, work phone number, and request Sandy to provide detail on how she is authorized to make decisions for the enrollee. This is important to ensure that the case worker has the necessary authorization to enroll Michael Gordon into CMS. By documenting this information and requesting further details, the agent can verify Sandy's credentials and determine if she is authorized to proceed with the call and complete the enrollment process.

The correct answer is to advise Roger to fax in legal documentation (POA), complete verification, and continue with the call. This is because even though Roger claims to have Power of Attorney, it is important to have proper legal documentation to verify his authority. By requesting him to fax in the POA, the agent can ensure that Roger is authorized to speak on behalf of his mother and proceed with the enrollment process.

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The agent should not continue with the call because the caller must verify the name and year of birth to pass verification. In this case, Justin Taylor is calling to enroll his wife Brittany into a plan, but he cannot verify her correct year of birth. Therefore, the agent should refer to DCF/SSA to verify or update Brittany's year of birth before proceeding with the call.

The agent cannot continue with the call unless there is emancipation paperwork on file in HealthTrack history. This suggests that Jodie Williams, being 15 years old and having just had a baby, may not have the legal capacity to enroll herself into Sunshine State Health Plan without the proper documentation of emancipation.

The correct answer is to continue the call and advise Mrs. Ramos to send in the letter documenting her authority by fax, email, or U.S. mail. This is the appropriate course of action because Mrs. Ramos does not have the pin number, but she claims to have a letter from her daughter giving her permission to act on her grandchildren's behalf. By requesting the letter, it allows for proper verification and documentation of her authority, ensuring that the necessary changes can be made.

The correct answer is "Yes, if the caller requests to change the Security PIN number." This means that the agent has the ability to change or update the Security PIN number if the caller specifically asks for it.

If Sue has the PIN but is not listed on her mother's case, the appropriate course of action would be to tell Sue that she can submit a DAR form via email, mail, or fax and continue with the verification process. This would allow Sue to provide the necessary documentation to prove her authority to access her mother's affairs and continue the call.

If the caller cannot verify the zip code for Suzanne Robinson's physical address, the best course of action is to attempt to verify the address two more times. If these attempts are also unsuccessful, it is recommended to refer to the Department of Children and Families (DCF) or the Social Security Administration (SSA) to verify and/or update the address. This ensures that the correct and up-to-date address is used for any necessary communication or documentation.

This statement is true because disclosing Protected Health Information (PHI) without proper verification is a violation of privacy laws and regulations. PHI includes any personal health information that can be used to identify an individual, such as medical records, treatment history, or insurance information. To ensure patient confidentiality and protect sensitive data, it is crucial to verify the identity and authorization of individuals before sharing any case information. Failure to do so can lead to serious consequences, including legal penalties and a failed call.

The statement "The caller is automatically authorized if they have the PIN" is false. The presence of a PIN does not automatically authorize the caller. While the PIN may be a factor in the authorization process, there could be other criteria or steps that need to be fulfilled in order for the caller to be authorized.

The correct answer is that Robert cannot change plans at this time because he now lives in a different region from what's listed in Health Track. The explanation for this is that Health Track still shows Pasco County as Robert's location, but he claims to now live in Liberty County. In order to update his address and proceed with a plan change, it is necessary for Robert to contact DCF/SSA to update his address information.

The correct answer is to continue with the call without referring because Teresa has verified her current mailing address. While she does not have a physical address, this does not prevent her from continuing with the call.

The agent should ask the caller to provide the mailing address first and then confirm if the mailing address is correct. This ensures that the agent has accurate information and can verify if the address on file matches the provided address.

The correct answer is to verify if Lawrence is on the case. If he is not, ask if he has authority to make changes on his wife's case and request the DAR. This is the appropriate procedure because even though Lawrence has the PIN number, it does not automatically grant him authorization to enroll his wife into a LTC plan. Therefore, it is important to confirm if he is listed on the case or if he has the authority to make changes on his wife's behalf. Requesting the DAR (Designated Authorized Representative) will help ensure that the appropriate person is authorized to make decisions regarding the enrollment.

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The agent should respond by informing Ms. Morton that the Security PIN number can be found on the welcome letter.

The agent is not allowed to disclose the Security PIN number unless it has already been confirmed by the caller. Agents can only change/update the PIN number. This is to ensure the security and privacy of the caller's personal information.

The correct answer is to ask Rosa whether she has authority for Ashley because she does not have the PIN, and continue with verification because she is the parent. This is the appropriate course of action because even though Rosa does not have the PIN number, she is the parent of Ashley and therefore likely has the authority to make changes on her behalf. It is important to verify this information before proceeding with the call.

The correct answer is to verify the full name, year of birth, and physical address for one of the three children and only verify the full names of the other two children. This option allows for the necessary verification of information for at least one child, while also recognizing that the other two children do not need their full information verified. This approach ensures efficiency while still meeting the necessary requirements for enrollment.