Final Review

How many questions are there in the HIPAA V&A tool?

• 2

• 3

• 4

• 6

What must you inform a member of before dis-enrolling them?

• That they cant do it

• The complaint and appeal process

• Any market specific lock in program information

• open enrollment period

A member calls to see if her family member has been added as a HIPAA designated rep. How do we document this request?

• privacy breack

• Use the privacy assistance task in compass

• we dont

• As the caller to resubmit the form

If a member calls and wants to know if a spinal manipulation is covered what benefit would you look under?

• DME

• Diagnostic Testing

• Out Patient Services

• Chiropractic Service

Which of these are considered a primary care provider?

• Dermatolgst

• Family Medicine

• Podiatrist

• OBGYN

How many doctors do we try to give a member calling in looking for a new one?

• 2

• 1

• 3

• 4

Which one these best describes an authorization?

• inpatient only

• specific to date and provider

• transferable to any provider

• outpatient only

When might you call 9-1-1 on behalf of a member

• the member says she is having a medical emergency

• there is a gun in the house for harm

• we never call 9-1-1

• if the member asks us to