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scenario W023149748

Total questions: 10

Worksheet time: 50mins

Name
Class
Date
1.

Melanie is calling you to order an ID card. Which tab and button would you click in ASD to help her

a)

Member Tab > member preferences

b)

Benefits tab > Plan remarks

c)

Plan Tab > ID Card Request

d)

Summary Tab > Accumulators

2.

Before you order the ID card, what must you verify

a)

phone number

b)

address

c)

member's social

d)

if they want it in paper or plastic mode

3.

Melanie wants to go to a dermatologist, what is her benefit?

a)

80% after deductible

b)

100% after $25.00 Copay

c)

Not covered

d)

100% after $50.00 copay

4.

Find her the closest dermatologist. What is the name of the first provider you find

a)

Alfred Hockley

b)

Eloise Atkinson-Garza

c)

Chad Hivnor

d)

Dermatology Associates

5.

Is Dr. Atkinson-garza accepting new patients

a)

yes

b)

no

c)

I don't know

6.

what is Dr. Atkinson's Phone number

a)

2104904795

b)

2104904661

c)

2108675309

d)

21012345678

7.

While she has you on the phone, Melanie wants to know why you denied the claim for DOS 08/05/19

a)

We didn't feel like paying it then

b)

There is no precert on file because she used an out of network provider

c)

There isn't a denied claim for that day

8.

Do we have a precert on file for DOS 08/05/2019?

a)

yes

b)

no

9.

will Melanie be then responsible for these charges from 08/05/2019?

a)

possibly

b)

Of course not

c)

No, put it on my tab

d)

yes

10.

Since she has you on the phone, she wants to know if she has met her deductible for the year

a)

Yes, she has met her $750.00 deductible

b)

Yes , she has met her $4500.00 deductible

c)

No, she has not met her $750.00 deductible

d)

No, she has not met her $4500.00 deductible