Out of Scope Plans

Out of Scope Plans

Professional Development

10 Qs

quiz-placeholder

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Out of Scope Plans

Out of Scope Plans

Assessment

Quiz

Other

Professional Development

Easy

Created by

Arjay John Suson

Used 15+ times

FREE Resource

10 questions

Show all answers

1.

MULTIPLE SELECT QUESTION

45 sec • 3 pts

What plans are considered as Out of Scope plans. (Select all that applies)

Medicaid Policy

DSNP Policy

Medicare Policy

Commercial Non-Offshorable Policy

2.

MULTIPLE CHOICE QUESTION

30 sec • 1 pt

If a member's carrier name has Medicaid indicator, what queue should it be transferred to?

CLRX_AHD_PAT_Transfer

CLRX_AHD_PAT

CLRX_AHD_PAT_Medicaid

3.

MULTIPLE CHOICE QUESTION

30 sec • 1 pt

What specific tool do we utilize to determine if the policy is Medicaid, GRS or DSNP?

PST

COS

ERx

One Note

4.

MULTIPLE CHOICE QUESTION

30 sec • 1 pt

What does DSNP stands for?

Dual Selection Needs Plan

Dual Social Needs Plan

Dual Special Needs Plan

Dual Specification Needs Plan

5.

MULTIPLE CHOICE QUESTION

30 sec • 1 pt

What does GRS stands for?

Group Resolution Selections

Group Retiree Solutions

Grievance Resignation Solutions

6.

MULTIPLE CHOICE QUESTION

30 sec • 1 pt

What specific queue do we transfer GRS and DSNP plans?

CLRX_AHD_PAT_Transfer

CLRX_AHD_PAT

CLRX_AHD_PAT_Medicaid

CLRX_AHD_PAT_Transformers

7.

MULTIPLE CHOICE QUESTION

30 sec • 1 pt

Offshore associates are not allowed to handle these policies and they need to transfer the call to the Dedicated queues

Sample Group Name: Kroger

Commercial Offshorable group

Commercial Non-offshorable group

GRS policy

Medicare Policy

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