WorksheetsAssessment PST Week 3 Medicare
Total questions: 21
Worksheet time: 21mins
Which of these tools is used only to know the correct route when documenting a case?
Case Routing Grid
Benefit Grid
Sales Force
TruCare
Which of these tools is used to know the covered services and characteristics of each medical plan?
Case Routing Grid
Benefit Grid
Job Aid
Call Transfer Guide
If you see this code "H78" on ePACES that's mean that member is _____________
INN
OFF Exchange
On Exchange
OON
___________ can assist if no changes are needed on the renewal application.
They can also help determine if the member is eligible for Medicaid.
SSA
HRA
NYSOH
My Advocate
What means NYSOH?
(a)
If is the ___ or more time times, process with the expedited mail.
3rd
2nd
1st
9th
What is the name of the form that members must send if they need more transportation services? (Medicaid)
9510 Form
2015 Form
MAS Forrm
Transportation Form
Who coordinates transportation for Medicaid plans?
MAS
MovidCare
Logisticare
Transportation Department HF
What is the option that you must select to find a member in Advanced Search? TC
Plan number
ID member
SSN
Policy number
In which of these options can we see the CM information? TC
(a)
To view incoming documents, you must select _________
To view outgoing correspondences , you must select _______
TC
Correspondence
Documents
Incoming Fax
Documents
Correspondence
More Documents
Notes
is this the correct process to enter a task? TC
No
Yes
Is the person assigned for HF to manage members day to day needs, identify problems early, and adjust the care plan to help members stay in their home for as long as possible.
Care Manager
Primary Care Provider
Home Attendant
Nurse
What information appears on the second page of an authorization? PDF
Authorization's number
Primary Diagnosis
Status
Provider info
Do we need all this info to document a Billing Inquiry?
- DOS
- Amount (do not include $)
- Account number
- Provider info (name, ID, phone, address)
- Claim # (if available // 000 000 000 000 0)
Yes
no
If the claim has the correct Provider’s name and DOS in the system that matches the bill, but the amount of the claim is different, assume the claim is ______
denial
on file
not on file
surprise bill
If the provider’s name and DOS is not found, assume that the claim is _______
denial
on file
not on file
surprise bill
We must to sent this form during a Surprise Bill call _____
Explanation of Benefits
Not on file form
Appeal form
Assignment of Benefits
In which tool do you see the documents faxed to 646?
Macess
Trucare
Sales Force
OnContact
In which tool do you see the documents faxed to 212?
Macess
Trucare
OnContact
Correspondence
Is this the correct route to document a Billing Inquiry?
Yes
No
