Part C Benefits
Quiz by Ashley Jones
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- Q1
What is the copayment for Cardiac Therapist for a CareComplete member in Brevard County?
Specialist $45/Outpatient Hospital $45
Specialist $20/Outpatient Hospital $25
Specialist $0/Outpatient Hospital $5
Specialist $30/Outpatient Hospital $30
60s - Q2
What tab on the Benefits Grid provides information about specific benefits available to certain Medicaid members?
Medicaid Code Descriptions
Medicaid Wrap Benefits tab
Benefit Explanations
Benefit Code Descriptions
60s - Q3
What are benefits mandated by Original Medicare that must be provided by the MA plan?
Optional Supplemental Benefits
Mandatory Medicare Benefits
Mandatory Supplemental Benefits
Part D Benefits
60s - Q4
The emergency ground ambulance copay for a CareFree member in Palm Beach County is $200.
truefalseTrue or False60s - Q5
Maria, a CareFree Plus member who lives in Dade County, calls stating her neurologist would like for her to complete an overnight sleep assessment at Palmetto General Hospital. What is Maria's copay under her plan? (**Number only. No symbols.**)
Users enter free textType an Answer60s - Q6
You take a call from Jeffrey who is requesting to have his current Evidence of Coverage sent to him. What STC do you use and what mailing timeframe do you advise Jeffrey?
CP846; up to 14 days
C0201; up to 7 calendar days
CP846; up to 10 business days
CP994; up to 10 business days
60s - Q7
What are CarePlus' preferred diabetic testing supply manufacturers?
Users sort answers between categoriesSorting60s - Q8
Place the benefit in the correct category.
Users sort answers between categoriesSorting60s - Q9
CP994 is used for benefits that are coded as what color on the Benefits Grid?
Users enter free textType an Answer30s - Q10
The full DME list can be found on the Benefits Grid.
falsetrueTrue or False30s - Q11
What command do you enter in this CSIM screen to review a member's PBP code?
Users enter free textType an Answer30s - Q12
This member's PBP code is ___________.
CareOne Palm Beach
102
10490
H1019
30s - Q13
A diagnostic screening is considered a routine procedure.
falsetrueTrue or False30s - Q14
Match the provider to the appropriate service type.
Users sort answers between categoriesSorting60s - Q15
If Linda has a $5000 MOOP, she has already met her $1000 deductible, she pays 10% of all specialist visits, and shows a total accumulation for the year of $4162, how much more will she need to put out of her pocket until she reaches her MOOP?
$1838
$4000
$500
$838
60s