SMMC Refresher Quiz #9

1. A father calls to change his child's plan. When you access the case, you see the father is 17 years old. How should you proceed?

Continue with verification and determine if a plan change is possible.

Advise the father we cannot speak to minors and ask to speak to an adult.

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Verification

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2. A member needs to change the plan, but during verification you are informed there is someone else on the line. They introduce themselves as a representative from Sunshine Health. How should you proceed?

Ask the member if it is OK to proceed with the representative on the line.

3. A member completes verification and gives permission for their mother to take over the call. How should you proceed?

Advise the member that their mother will need to complete verification before we continue.

Continue the call with their mother. A member can authorize someone else to speak on their behalf after verification.

4. A parent needs to change the plan for their child. When verifying the year of birth, the parent verifies 2016 instead of the year on the case (2015). How should you proceed?

Continue with verification. The parent does not have to verify the correct year of birth.

5. The member does not have their Medicaid ID or Gold Card number. What is the next number you can ask for to attempt to access the case?

A Case Number.

A Medicare ID Number.

A Social Security Number.

A Credit Card Number.

6. The caller states, "I'm calling on behalf of my neighbor. She's elderly and recently had a stroke so it is difficult for her to communicate. She has asked me to help enroll her into a plan. I'm not her legal representative, but she gave me permission to help her and I have all of her information here." How should you proceed?

7. This mother needs to change the plan for her child. How should you proceed?

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Current Version
Mar 20, 2022

Quiz Edited by
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Jul 11, 2017

Quiz Created by
AHSFLTrainer

Smmc Refresher Quiz #9