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Part C Benefits

Quiz by Ashley Jones

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20 questions
Show answers
  • Q1

    What is the copayment for Cardiac Therapist for a CareComplete member in Brevard County?

    Specialist $35/Outpatient Hospital $35

    Specialist $0/Outpatient Hospital $5

    Specialist $45/Outpatient Hospital $45

    Specialist $20/Outpatient Hospital $25

    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 $300.

    true
    false
    True or False
    60s
  • Q5

    Maria, a CareFree Platinum 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 text
    Type an Answer
    60s
  • 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 categories
    Sorting
    60s
  • Q8

    Place the benefit in the correct category.

    Users sort answers between categories
    Sorting
    60s
  • Q9

    CP994 is used for benefits that are coded as what color on the Benefits Grid?

    Users enter free text
    Type an Answer
    30s
  • Q10

    The full DME list can be found on the Benefits Grid.

    false
    true
    True or False
    30s
  • Q11

    What command do you enter in this CSIM screen to review a member's PBP code?

    Question Image
    Users enter free text
    Type an Answer
    30s
  • Q12

    This member's PBP code is ___________.

    Question Image

    CareOne Palm Beach

    102

    10490

    H1019

    30s
  • Q13

    A diagnostic screening is considered a routine procedure.

    false
    true
    True or False
    30s
  • Q14

    Match the provider to the appropriate service type.

    Users sort answers between categories
    Sorting
    60s
  • 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

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