CE - MBC Mid-Training Review

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CE - MBC Mid-Training ReviewVersión en línea Review quiz of all topics covered thus far in MBC Medicaid Onboarding por Meridian Training 1 What does the Third Party Liability screen in MCS show you? a The provider write-off amount (the amount of money the member is not liable to pay) b Meridian enrollment data c Family members connected to the account d Other insurance the member has 2 If a member's date of birth is incorrect in MCS, you should navigate to the demographics screen and update it. a True b False 3 What is this button used for? a Accessing Contact Reports b Accessing CHAMPS c Accessing Eligibility/PCP History d Accessing Electronic Data in MCS 4 Which screen in MCS would you navigate to if you needed to change a member's PCP? a Eligibility/PCP History b Member Management c Demographics d Care Team/Auth Rep 5 How often is a member able to change his/her PCP? a Once a month b Once a day c Once every quarter d As often as they would like 6 Is CPT E0217 covered by Meridian in Michigan? a Yes, it is covered and does not require PA b Yes, it is covered, but it does require PA to be submitted for review c No, it is not covered by Meridian, but might be covered by the state of Michigan d No, it is not covered by Meridian or the state of Michigan 7 Is CPT code 30410 covered by Meridian in Michigan? a Yes, it is covered and does not require PA b Yes, it is covered, but does require PA to be submitted for review c No, it is not covered by Meridian, but might be covered by the state of Michigan d No, it is not covered by Meridian or the state of Michigan 8 Is CPT code 99213 covered by Meridian in Michigan? a Yes, it is covered and does not require PA b Yes, it is covered, but will require PA to be submitted for review c No, it is not covered by Meridian, but might be covered by the state of Michigan d No, it is not covered by Meridian or the state of Michigan 9 What is the Chiropractic benefit for a Michigan TANF member? a 18 visits per calendar year, must have approved PA on file b 18 visits per calendar year, PA required if OON c Covered for members who are 20 and under only, but there is no benefit visit limit d Covered for members who are 20 and under only, limited to 18 visits per fiscal year 10 A Michigan member calls in requesting listings for a Psychiatrist in his/her area, you should... a Advise the member that this Behavioral Health service is not covered through Meridian, but may be covered through the state of Michigan b Advise the member that this Behavioral Health service is not covered through Meridian or the state of Michigan c Locate Psychiatry listings in the member's area using the online provider search d Advise the member that he/she should visit a Psychologist or Therapist instead, since Psychiatrists only spend 20 minutes with their patients 11 Where should you navigate to if you need to locate your Medicaid Welcome Calls Job Aid a CE Department Site b CE Training Aids Library c Prime Meridian d mhplan.com 12 What are the requirements for Bariatric Surgery? Choose one or more answers a Member must prove 6 months of consecutive weight management b Member must be a member for at least 1 year c Member must have a BMI of 40 or grater d Member must be at least 18 years old 13 Which authorization form(s) need to be submitted to Meridian for a member to complete Weight Watchers? Choose one or more answers a Online Prior Authorization Form (ePA) b Weight Watcher's Letter of Commitment c Appointment of Representative (AOR) Authorization Form d Authorization for Release of Information Form 14 Where should you navigate to if you need to find a list of providers that accept Meridian Health insurance? a CE Department Site b CE Training Aids Library c Prime Meridian d mhplan.com 15 Which MCS button would you select to send a new ID card to a member? a b c d 16 What will you code in the contact log if you check a CPT code for a member? (i.e. check coverage status and PA requirements in the CBT) Written answer 17 What will you code in the contact log if you verify a member's PCP? Written answer 18 What will you code in the contact log if you advise a member of a future termination date on his/her account? Written answer 19 What will you code in the contact log if you transfer the caller to a different team/department? Written answer 20 If you are submitting to NotifyMHP because a member is moving out of state, what will your Notification Type and Type of Action be? a Enrollment; Eligibility Issue b Case Management; Out-of-State Disenrollment c Case Management; Eligibility Issue d Enrollment; Out-of-State Disenrollment 21 If you are submitting to Notify MHP because a member has a primary insurance that is not currently in MCS, what will your Notifcation Type and Type of Action be? a Case Management; Coordination of Benefits b Claims; Coordination of Benefits c Case Management; Certificate of Coverage d Enrollment; Coordination of Benefits 22 If you are submitting to Notify MHP because a member needs to be enrolled into Care Coordination, what will your Notification Type and Referral Reason be? a Case Management; Coord of Care b Enrollment; Disease Managment c Case Management; CC Enrollment d Enrollment: Coord of Care 23 Can a minor member have two parents listed on his/her Care Team Screen? a Yes b No 24 If a member is unable to provide his/her Meridian ID number, we can ask for name, date of birth, and full mailing address to verify him/her. a True b False 25 We can give provider listings to an unverified caller as long as they provide us with the zip code to look up the providers. a True b False

CE - MBC Mid-Training ReviewVersión en línea

Review quiz of all topics covered thus far in MBC Medicaid Onboarding

por Meridian Training

What does the Third Party Liability screen in MCS show you?

The provider write-off amount (the amount of money the member is not liable to pay)

Meridian enrollment data

Family members connected to the account

Other insurance the member has

If a member's date of birth is incorrect in MCS, you should navigate to the demographics screen and update it.

True

False

What is this button used for?

Accessing Contact Reports

Accessing CHAMPS

Accessing Eligibility/PCP History

Accessing Electronic Data in MCS

Which screen in MCS would you navigate to if you needed to change a member's PCP?

Eligibility/PCP History

Member Management

Demographics

Care Team/Auth Rep

How often is a member able to change his/her PCP?

Once a month

Once a day

Once every quarter

As often as they would like

Is CPT E0217 covered by Meridian in Michigan?

Yes, it is covered and does not require PA

Yes, it is covered, but it does require PA to be submitted for review

No, it is not covered by Meridian, but might be covered by the state of Michigan

No, it is not covered by Meridian or the state of Michigan

Is CPT code 30410 covered by Meridian in Michigan?

Yes, it is covered and does not require PA

Yes, it is covered, but does require PA to be submitted for review

No, it is not covered by Meridian, but might be covered by the state of Michigan

No, it is not covered by Meridian or the state of Michigan

Is CPT code 99213 covered by Meridian in Michigan?

Yes, it is covered and does not require PA

Yes, it is covered, but will require PA to be submitted for review

No, it is not covered by Meridian, but might be covered by the state of Michigan

No, it is not covered by Meridian or the state of Michigan

What is the Chiropractic benefit for a Michigan TANF member?

18 visits per calendar year, must have approved PA on file

18 visits per calendar year, PA required if OON

Covered for members who are 20 and under only, but there is no benefit visit limit

Covered for members who are 20 and under only, limited to 18 visits per fiscal year

A Michigan member calls in requesting listings for a Psychiatrist in his/her area, you should...

Advise the member that this Behavioral Health service is not covered through Meridian, but may be covered through the state of Michigan

Advise the member that this Behavioral Health service is not covered through Meridian or the state of Michigan

Locate Psychiatry listings in the member's area using the online provider search

Advise the member that he/she should visit a Psychologist or Therapist instead, since Psychiatrists only spend 20 minutes with their patients

Where should you navigate to if you need to locate your Medicaid Welcome Calls Job Aid

CE Department Site

CE Training Aids Library

Prime Meridian

mhplan.com

What are the requirements for Bariatric Surgery?

Choose one or more answers

Member must prove 6 months of consecutive weight management

Member must be a member for at least 1 year

Member must have a BMI of 40 or grater

Member must be at least 18 years old

Which authorization form(s) need to be submitted to Meridian for a member to complete Weight Watchers?

Choose one or more answers

Online Prior Authorization Form (ePA)

Weight Watcher's Letter of Commitment

Appointment of Representative (AOR) Authorization Form

Authorization for Release of Information Form

Where should you navigate to if you need to find a list of providers that accept Meridian Health insurance?

CE Department Site

CE Training Aids Library

Prime Meridian

mhplan.com

Which MCS button would you select to send a new ID card to a member?

What will you code in the contact log if you check a CPT code for a member? (i.e. check coverage status and PA requirements in the CBT)

Written answer

What will you code in the contact log if you verify a member's PCP?

Written answer

What will you code in the contact log if you advise a member of a future termination date on his/her account?

Written answer

What will you code in the contact log if you transfer the caller to a different team/department?

Written answer

If you are submitting to NotifyMHP because a member is moving out of state, what will your Notification Type and Type of Action be?

Enrollment; Eligibility Issue

Case Management; Out-of-State Disenrollment

Case Management; Eligibility Issue

Enrollment; Out-of-State Disenrollment

If you are submitting to Notify MHP because a member has a primary insurance that is not currently in MCS, what will your Notifcation Type and Type of Action be?

Case Management; Coordination of Benefits

Claims; Coordination of Benefits

Case Management; Certificate of Coverage

Enrollment; Coordination of Benefits

If you are submitting to Notify MHP because a member needs to be enrolled into Care Coordination, what will your Notification Type and Referral Reason be?

Case Management; Coord of Care

Enrollment; Disease Managment

Case Management; CC Enrollment

Enrollment: Coord of Care

Can a minor member have two parents listed on his/her Care Team Screen?

Yes

If a member is unable to provide his/her Meridian ID number, we can ask for name, date of birth, and full mailing address to verify him/her.

True

False

We can give provider listings to an unverified caller as long as they provide us with the zip code to look up the providers.

True

False

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