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Dental Calls refresher

Total questions: 10

Worksheet time: 5mins

Name
Class
Date
1.

MID: 900990425

Jacqueline wanted to check if extractions are included in her insurance. Is it covered?

a)

YES

b)

NO

2.

Use Live Research in Maestro

MID: 832095750

Can the member get a dental rider?

a)

Yes

b)

No

3.

Use Live Research in Maestro

MID: 832095750

Rob stated he will be having his alveoloplasty this year and wanted to know how much is for the dental procedure?

a)

50%

b)

$0.00

4.

Use Live Research in Maestro

MID: 832095750

Rob provided a dental code, D1110. He is asking for the frequency limitations of this dental procedure?

a)

1 per 1 plan year

b)

1 per 2 plan year

c)

2 per 1 plan year

d)

2 per 2 plan year

5.

Use Live Research in Maestro

MID: 832095750

What is his Maximum Allowable amount for his Routine Dental?

a)

$500

b)

$1000

c)

$1500

d)

$2500

6.

Use Live Research in Maestro

MID: 832095750

Rob stated he cant afford Dental Rider, what would you do?

a)

Educate the member we cannot do anything about it.

b)

Offer Find help

c)

Contact UHOne first to inquire about stand alone plans.

d)

Offer Delta Dental right away.

7.

Member wanted to get a rider and his plan's effective date is June 1, 2023. (Lets assume its July 20, 2023 today). You advised the member you can enroll the member and the plan effective date would be the first of the following month.

a)

True

b)

False

8.

A member who have a plan with a rider rolling over to a new plan year can add a rider during ______.

a)

AEP

b)

RSS

c)

MRS

d)

PDP

9.

A member called in and wanting to verify an issue with his claims but when checked, this cannot be resolved within Maestro. What would you do?

a)

Educate the member we are having an error in our system.

b)

Warm Transfer to their dental vendor. If the dental team cannot assist, request they escalate the call to SST.

c)

Cold transfer to UHC Dental for further assistance.

10.

Dental number can be provided to the caller even he/she didn't request for it.

a)

True

b)

False