Level 2 - Enrollment & Providers
Quiz by Ashley Jones
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- Q1
What enrollment period runs from January 1 through March 31 every year?
ICEP
MAOEP NEW
MAOEP
AEP
30sEditDelete - Q2
What enrollment period runs from October 15 through December 7 every year?
AEP
MAOEP
ICEP
MAOEP NEW
30sEditDelete - Q3
For how many total months does an individual's ICEP run?
7
6
3
9
30sEditDelete - Q4
Which of the following are examples of SEP qualifying events?
Users sort answers between categoriesSorting60sEditDelete - Q5
A member calling to cancel their application before the effective date is classified as a disenrollment.
falsetrueTrue or False30sEditDelete - Q6
When leveraging the MARX system to complete research for a member, what STC is used to document that action?
Users enter free textType an Answer45sEditDelete - Q7
You will use STC CP009 when a member request a replacement ID card.
falsetrueTrue or False45sEditDelete - Q8
The Benefits Grid will list a member's applicable Part B Premium Reduction as a:
Debit
Rebate
Discount
Credit
60sEditDelete - Q9
Which of the following is NOT an acceptable means by which a member can request to disenroll from CarePlus?
Completed CPHP Disenrollment Form
Handwritten letter
Faxed letter
Verbal request
30sEditDelete - Q10
Categorize the providers:
Users sort answers between categoriesSorting60sEditDelete - Q11
Match the maximum distance requirement with the County and Provider.
Users link answersLinking120sEditDelete - Q12
What is the mailing timeframe for a replacement member ID card?
Up to 7 business days
Up to 10 calendar days
Up to 7 calendar days
Up to 10 business days
60sEditDelete - Q13
How long is the standard mailing timeframe for a printed Provider Directory?
Up to 10 calendar days
Up to 7 calendar days
Up to 10 business days
Up to 7 business days
60sEditDelete - Q14
Randall Cunningham's Part A became effective on 01/21/2021. His Part B wasn't effective until 03/18/2021. He selected Humana Medicare Advantage plan at the time of enrollment, but now wants to switch to CarePlus. Under the MAOEP NEW election period, what is the latest date Randall can apply for enrollment into CarePlus?
05/31/2021
06/18/2021
03/21/2021
03/31/2021
120sEditDelete - Q15
Sheryl Crow called in on 07/26/2021 requesting to change her PCP, and that she will need to be seen by the new PCP next month ahead of overseas travel. What PCP change will you file?
Standard PCP change effective 09/01/2021
Retroactive PCP change effective 07/01/2021
Exception PCP change effective 08/01/2021
Exception PCP change effective 09/01/2021
120sEditDelete - Q16
Which STC would you use to document a PCP change that can be completed at the time of the member's call?
Users enter free textType an Answer60sEditDelete - Q17
Providers listed on the Preclusion List are excluded from receiving payment for MA items and/or services beginning 60 calendar days after appearing on the List.
falsetrueTrue or False45sEditDelete - Q18
ICRs are able to process a telephonic plan change after determining that a member is within an eligible enrollment period.
falsetrueTrue or False30sEditDelete - Q19
The Par Provider Grid uses the assigned PCP's region code to determine the correlating Provider Network Coverage for each specialty.
truefalseTrue or False45sEditDelete - Q20
Which Authorization Code matches this description: "PCP must send authorization request to CPHP-HSO along with medical notes for determination."
Personal Home Care
FFS
Excluded (Refer to PCP)
Direct HHC Agencies
120sEditDelete