Medicaid UM Non Clinical Week 1

Where does Medicaid funding come from?

• Elevance Health

• Jointly funded by State and Federal

• Obamacare

• Employers

• Self Funded

What is SCHIP (or CHIP)?

• State Children's Health Insurance Program

• State Clause for Healthcare Insurance for Providers

• State Care Health Insurance Program

• A bag of Doritos

What does Dual Eligible mean?

• Member has two insurance plans with Elevance

• Member is eligible for two Medicaid products

• Member is eligible for both Medicare and Medicaid

• Both spouses are eligible for Medicaid

What does ADLs stand for?

• Activities of Daily Living

• Anthem Daily Life Insurance

• Assisted Daily Living

• Access to Denial Letters

What is Utilization Management?

• A department that handles all appeals

• Management for inpatient hospital stays

• Your Medicaid manager's title

• Process of evaluating the appropriateness and efficiencies of health care services

How many identifiers do you need to verify with the caller or fax to ensure HIPAA is met for the member?

• None

• 1

• 2

• 3

Where are you able to store computer passwords?

• Your cellphone

• Near your desk

• Locked in a drawer in your home

• On your laptop

Who qualifies for LTSS?

• Anyone over 65 years of age

• Anyone under 19 years of age

• Seniors and those with disabilities or chronic needs

• Elevance members only

True or False: You do not have to lock your computer if you are working at home alone

• True

• False

What is the name of the system where MMS associates will build a case when a provider requests a service?

• Facets

• Macess

• AUMI

• ACMP