UHC UNITED HEALTHCARE COMPREHENSIVE
UPDATED ALL QUESTIONS AND ANSWERS SURE
A+
✔✔Bonnie, a D-SNP member, lost her Medicaid eligibility. She has a Special Election
Period available to enroll in a new plan. When does that begin? - ✔✔Upon notification
or effective date of the loss, which ever is earlier
✔✔Harold lost his Medicaid eligibility. What is he responsible for paying? (select all that
apply) - ✔✔1. Deductibles
2. Copayments
3. Coinsurance
✔✔What are the reasons a consumer can use the Special Election Period- Special
Need/Chronic? (select all that apply) - ✔✔1. Enrolling in a C-SNP first time
2. Enrolling in a C-SNP to cover a different condition
✔✔Mrs. Murphy has recently been diagnosed with a cardiovascular disorder and wants
to enroll in a C-SNP. Joshua asked her about a provider who can verify her condition.
What is true about her provider? - ✔✔The provider indicated on the form does not have
to be contracted with the plan.
, ✔✔Mrs. Murphy's effective date is February 1. She receives a letter on March 1 from
the plan telling her the attempts to verify her qualifying chronic condition have been
unsuccessful. What does this mean? - ✔✔Her enrollment will be terminated effective
March 31 if, as of March 31, the plan has not been able to verify a qualifying chronic
condition
✔✔If the enrollee has not resided in the contracted SNF for 90 days at the time of
enrollment, which documents qualify as additional proof to be submitted to the
enrollment department? (select all that apply) - ✔✔1. MDS (Minimum Data Set) forms;
Sections A0100 - A1100 and Section Q0300-Q0400
2. An Optum-provided form letter signed by appropriate facility staff
3. An approved letter on facility letterhead signed by appropriate facility staff
✔✔Which election periods can be used at any time during the year to enroll an eligible
consumer into an ISNP? - ✔✔Open Enrollment Period for Institutionalized Individuals
(OEPI)
✔✔Now that you read the Provider Activity Guidelines, which statement below is true? -
✔✔The skilled nursing facility staff member cannot provide a completed BRC directly to
an agent but may put it in a drop box or folder used to collect completed BRCs.
✔✔Authorization for Disclosure of Contact Information: Signed within the previous
twelve-month period - ✔✔Required
✔✔Authorization for Disclosure of Contact Information: No expiration date - ✔✔Not
Required
✔✔Authorization for Disclosure of Contact Information: Anyone from the contracted skill
nursing facility can sign - ✔✔Not Required
✔✔Authorization for Disclosure of Contact Information: A description of entities to which
the information is to be released - ✔✔Required
✔✔Authorization for Disclosure of Contact Information: Information will be given to a
health care plan - ✔✔Required
✔✔Authorization for Disclosure of Contact Information: Indicates someone will contact
them - ✔✔Required
✔✔Authorization for Disclosure of Contact Information: Individual will be enrolled in an I-
SNP - ✔✔Not Required
UPDATED ALL QUESTIONS AND ANSWERS SURE
A+
✔✔Bonnie, a D-SNP member, lost her Medicaid eligibility. She has a Special Election
Period available to enroll in a new plan. When does that begin? - ✔✔Upon notification
or effective date of the loss, which ever is earlier
✔✔Harold lost his Medicaid eligibility. What is he responsible for paying? (select all that
apply) - ✔✔1. Deductibles
2. Copayments
3. Coinsurance
✔✔What are the reasons a consumer can use the Special Election Period- Special
Need/Chronic? (select all that apply) - ✔✔1. Enrolling in a C-SNP first time
2. Enrolling in a C-SNP to cover a different condition
✔✔Mrs. Murphy has recently been diagnosed with a cardiovascular disorder and wants
to enroll in a C-SNP. Joshua asked her about a provider who can verify her condition.
What is true about her provider? - ✔✔The provider indicated on the form does not have
to be contracted with the plan.
, ✔✔Mrs. Murphy's effective date is February 1. She receives a letter on March 1 from
the plan telling her the attempts to verify her qualifying chronic condition have been
unsuccessful. What does this mean? - ✔✔Her enrollment will be terminated effective
March 31 if, as of March 31, the plan has not been able to verify a qualifying chronic
condition
✔✔If the enrollee has not resided in the contracted SNF for 90 days at the time of
enrollment, which documents qualify as additional proof to be submitted to the
enrollment department? (select all that apply) - ✔✔1. MDS (Minimum Data Set) forms;
Sections A0100 - A1100 and Section Q0300-Q0400
2. An Optum-provided form letter signed by appropriate facility staff
3. An approved letter on facility letterhead signed by appropriate facility staff
✔✔Which election periods can be used at any time during the year to enroll an eligible
consumer into an ISNP? - ✔✔Open Enrollment Period for Institutionalized Individuals
(OEPI)
✔✔Now that you read the Provider Activity Guidelines, which statement below is true? -
✔✔The skilled nursing facility staff member cannot provide a completed BRC directly to
an agent but may put it in a drop box or folder used to collect completed BRCs.
✔✔Authorization for Disclosure of Contact Information: Signed within the previous
twelve-month period - ✔✔Required
✔✔Authorization for Disclosure of Contact Information: No expiration date - ✔✔Not
Required
✔✔Authorization for Disclosure of Contact Information: Anyone from the contracted skill
nursing facility can sign - ✔✔Not Required
✔✔Authorization for Disclosure of Contact Information: A description of entities to which
the information is to be released - ✔✔Required
✔✔Authorization for Disclosure of Contact Information: Information will be given to a
health care plan - ✔✔Required
✔✔Authorization for Disclosure of Contact Information: Indicates someone will contact
them - ✔✔Required
✔✔Authorization for Disclosure of Contact Information: Individual will be enrolled in an I-
SNP - ✔✔Not Required
