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Assessment PST Week 3 Medicare

Total questions: 21

Worksheet time: 21mins

Name
Class
Date
1.

Which of these tools is used only to know the correct route when documenting a case?

a)

Case Routing Grid

b)

Benefit Grid

c)

Sales Force

d)

TruCare

2.

Which of these tools is used to know the covered services and characteristics of each medical plan?

a)

Case Routing Grid

b)

Benefit Grid

c)

Job Aid

d)

Call Transfer Guide

3.

If you see this code "H78" on ePACES that's mean that member is _____________

a)

INN

b)

OFF Exchange

c)

On Exchange

d)

OON

4.

___________ can assist if no changes are needed on the renewal application.

They can also help determine if the member is eligible for Medicaid.

a)

SSA

b)

HRA

c)

NYSOH

d)

My Advocate

5.

What means NYSOH?

(a)  

6.

If is the ___ or more time times, process with the expedited mail.

a)

3rd

b)

2nd

c)

1st

d)

9th

7.

What is the name of the form that members must send if they need more transportation services? (Medicaid)

a)

9510 Form

b)

2015 Form

c)

MAS Forrm

d)

Transportation Form

8.

Who coordinates transportation for Medicaid plans?

a)

MAS

b)

MovidCare

c)

Logisticare

d)

Transportation Department HF

9.

What is the option that you must select to find a member in Advanced Search? TC

a)

Plan number

b)

ID member

c)

SSN

d)

Policy number

10.

In which of these options can we see the CM information? TC

(a)  

11.

To view incoming documents, you must select _________

To view outgoing correspondences , you must select _______

TC

a)

Correspondence

Documents

b)

Incoming Fax

c)

Documents

Correspondence

d)

More Documents

Notes

12.

is this the correct process to enter a task? TC

a)

No

b)

Yes

13.

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.

a)

Care Manager

b)

Primary Care Provider

c)

Home Attendant

d)

Nurse

14.

What information appears on the second page of an authorization? PDF

a)

Authorization's number

b)

Primary Diagnosis

c)

Status

d)

Provider info

15.

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)

a)

Yes

b)

no

16.

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 ______

a)

denial

b)

on file

c)

not on file

d)

surprise bill

17.

If the provider’s name and DOS is not found, assume that the claim is _______

a)

denial

b)

on file

c)

not on file

d)

surprise bill

18.

We must to sent this form during a Surprise Bill call _____

a)

Explanation of Benefits

b)

Not on file form

c)

Appeal form

d)

Assignment of Benefits

19.

In which tool do you see the documents faxed to 646?

a)

Macess

b)

Trucare

c)

Sales Force

d)

OnContact

20.

In which tool do you see the documents faxed to 212?

a)

Macess

b)

Trucare

c)

OnContact

d)

Correspondence

21.

Is this the correct route to document a Billing Inquiry?

a)

Yes

b)

No