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

Out of Scope Plans

Quiz
•
Other
•
Professional Development
•
Easy

Arjay John Suson
Used 15+ times
FREE Resource
10 questions
Show all answers
1.
MULTIPLE SELECT QUESTION
45 sec • 3 pts
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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