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Level 2 - Enrollment & Providers

Quiz by Ashley Jones

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20 questions
Show answers
  • Q1

    What enrollment period runs from January 1 through March 31 every year?

    ICEP

    MAOEP NEW

    MAOEP

    AEP

    30s
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    Delete
  • Q2

    What enrollment period runs from October 15 through December 7 every year?

    AEP

    MAOEP

    ICEP

    MAOEP NEW

    30s
    Edit
    Delete
  • Q3

    For how many total months does an individual's ICEP run?

    7

    6

    3

    9

    30s
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    Delete
  • Q4

    Which of the following are examples of SEP qualifying events?

    Users sort answers between categories
    Sorting
    60s
    Edit
    Delete
  • Q5

    A member calling to cancel their application before the effective date is classified as a disenrollment.

    false
    true
    True or False
    30s
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    Delete
  • Q6

    When leveraging the MARX system to complete research for a member, what STC is used to document that action?

    Users enter free text
    Type an Answer
    45s
    Edit
    Delete
  • Q7

    You will use STC CP009 when a member request a replacement ID card.

    false
    true
    True or False
    45s
    Edit
    Delete
  • Q8

    The Benefits Grid will list a member's applicable Part B Premium Reduction as a:

    Debit

    Rebate

    Discount

    Credit

    60s
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  • 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

    30s
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    Delete
  • Q10

    Categorize the providers:

    Users sort answers between categories
    Sorting
    60s
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    Delete
  • Q11

    Match the maximum distance requirement with the County and Provider.

    Users link answers
    Linking
    120s
    Edit
    Delete
  • 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

    60s
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    Delete
  • 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

    60s
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    Delete
  • 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

    120s
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    Delete
  • 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

    120s
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    Delete
  • 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 text
    Type an Answer
    60s
    Edit
    Delete
  • 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.

    false
    true
    True or False
    45s
    Edit
    Delete
  • Q18

    ICRs are able to process a telephonic plan change after determining that a member is within an eligible enrollment period.

    false
    true
    True or False
    30s
    Edit
    Delete
  • Q19

    The Par Provider Grid uses the assigned PCP's region code to determine the correlating Provider Network Coverage for each specialty.

    true
    false
    True or False
    45s
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    Delete
  • 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

    120s
    Edit
    Delete

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