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Exam (elaborations)

Centene Midterm 50 questions with complete solutions already passed!!

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Centene Midterm 50 questions with complete solutions already passed!! How long can member be out of their area without being disenrolled? Over 6 months 1 year Less than 6 months 8 months Less than 6 months Who is the Medicare Part B monthly premium paid to? CMS The member Private insurance company CMS How does a member request to sign up for an Optional Supplemental Benefits package? Call and speak with the Sales Department Online through the Member Service Portal Request to meet with a Broker in person Mail in the Optional Benefits Individual Enrollment Form Mail in the Optional Benefits Individual Enrollment Form An example of Concierge Customer Service would be anticipating a member's needs and going out of your way to minimize a caller's effort. True False True Which of the following actions would require you to leave a note within the intent? (Pick 2) If you had to make an outgoing call If the intent captures all relevant information If you had to locate information outside of Omni You must include a note in every intent If you had to make an outgoing call If you had to locate information outside of Omni Which intents require the use of a template for the intent-level notes? (Pick 3) Pharmacy claims inquiry issues Medical claims inquiry Medical authorization inquiry Pharmacy authorization inquiry issues Medical authorization inquiry Pharmacy authorization inquiry If you open up the Gaps in Care intent and the member has none open, you would need to make note of that in the Final Call Summary field? True False False When can a DSNP member disenroll? (Pick 2) Annual Enrollment Period one time every month One time every quarter for the first 9 months of the year Anytime they want Twice every month of the year Annual Enrollment Period One time every quarter for the first 9 months of the year CSRs will inform callers of interpreter services being free. True False True How do you document prospective member and CMS test calls in Omni? Other action > Exit interaction Other action > Member not found > Benefits & Eligibility inquiry Other action > Member not found > Log view status No note is needed Other action > Member not found > Log view status The following items may be used for HIPPA verification except: Member name email Last 4 SSN Member date of birth Member ID number email It is permissible in some situations to provide medical advice to members. True False False When quoting PPO benefits to a member, you should quote both ____ and ____ benefits and cost shares? (Pick 2) In-Network Non-Covered Out of Network Covered In-Network Out of Network Transportation, Over the Counter, and Gym membership are examples of _________ _________. None of the ones mentioned Supplemental Benefits rewards Program Contest Prizes

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April 5, 2024
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Get instant access to a wide range of educational resources, practice quizzes, and study materials designed to empower nursing students. Enhance your knowledge, ace your exams, and build confidence with medtestpro's comprehensive collection of text-based

Get instant access to a wide range of educational resources, practice quizzes, and study materials designed to empower nursing students. Enhance your knowledge, ace your exams, and build confidence with medtestpro's comprehensive collection of text-based nursing resources.

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