Rose
Which statement best describes the typical living arrangement of
American seniors aged 65+?
A.Most live independently with a spouse or alone
B.Most live in assisted living facilities
C.Most live with extended family members
D.Most live in nursing homes
E.I don't know yet
A.Most live independently with a spouse or alone
In which phase do you ask probing questions to clarify the caller's needs
and set up documentation in Quick Start+?
A.Issue Identification Phase
B.Opening Phase
C.Resolution Phase
D.Closing Phase
E.I don't know yet
A.Issue Identification Phase
Where can you find the OMS link in CRM?
A.On the Plan Member page.
B.In QuickStart+.
C.Under the Interaction History tab.
D.On the ID-Card Management page.
E.I don't know yet
A.On the Plan Member page.
What are the prerecorded messages that provide information to
advocates about the transferred VAT call?
A.Whisper tones.
B.Transfer messages.
C.Dial tones.
D.VAT messages.
E.I don't know yet
A.Whisper tones.
What should you do if the template is not working to update the address?
A.Update member's address in CI.
B.Inform members they are unable to update their address.
C.Call the member back at a later date to update their address.
D.I don't know yet
A.Update member's address in CI.
Which models offer universal coverage?
A.Single payer & Multi-payer
B.Private payer only
C.Employer payer only
D.Cash only system
E.I don't know yet
Single payer & Multi-payer
In which of the following circumstances would full free-text
documentation be required in Quick Start+?
A.You were unable to close out the case.
B.The member account doesn't appear in CRM.
C.A member representative calls on the member's behalf.
D.The member isn't an Individual Medicare member.
I don't know yet
A.You were unable to close out the case.
Does each individual member receive their own Smart Summary?
A.Yes. Smart Summaries are specific to the claims and coverage for each member.
B.No. Smart Summaries cover all claim and coverage information for all parties in the household.
C.No. Smart Summaries cover all claim and coverage information for all parties on a plan.
D.It depends. Members must request their individual Smart Summary.
E.I don't know yet
A.Yes. Smart Summaries are specific to the claims and coverage
What system/tool will you use to verify a member’s date of death or a
name change?
A.MARx/Wipro
B.Debut
D.OMS
E.I don't know yet
A.MARx/Wipro
In which phase of the call flow do you make sure you've addressed all the
caller's issues and communicated the status of those issues?
A.Closing Phase
B.Opening Phase
C.Issue Identification Phase
D.Resolution Phase
E.I don't know yet
Closing Phase
Which of the following qualifies as an Eligibility Verification call?
A."Hi. I'm at the heart clinic here, and they say my plan's not coming up in their system, but I know I signed up for a new one. Can you check that for me?"
B."I'm calling to find out if I'm eligible for out-of-network surgery. There's a surgeon my friend recommended at Baptist East Hospital, and I'm pretty sure he's not in-network."
C."I'm calling to make sure my plan application is in process because I got a letter saying you needed more information from me."
D."Hi. I've moved, and I want to make sure my plan's still good here."
E.I don't know yet
A."Hi. I'm at the heart clinic here, and they say my plan's not coming up in their system, but I know I signed up for a new one. Can you check that for me?"
What classification and intent will you use in QuickStart + to document a
successful address change?
A.Demographics::Change
B.Demographics::No Change
C.Address::Change
D.Address::Update
E.I don't know yet
A.Demographics::Change
In which phase do you clarify the caller's identity and authority to receive
sensitive information about the plan in question?
A.Opening Phase
B.Issue Identification Phase
C.Resolution Phase
D.Closing Phase
DI don't know yet
A.Opening Phase
Which three pieces of information are key to resolving an Eligibility
Verification call?
A.Member's plan status / Member's plan type / Member's plan effective date
B.Member's Humana ID / Member's date of birth / Member's zip code
C.Member's Medicare ID / Member's date of birth / Member's Social Security Number
D.Member's residential address / Member's phone number /Member's email address
E.I don't know yet
A.Member's plan status / Member's plan type / Member's plan effective date
Which option should you choose to update a member's phone number or
email?
A.Contact Demographic Update
B.Critical Demographic Update
C.Address Update
D.I don't know yet
A.Contact Demographic Update
When will a member’s plan terminate once CMS has received notification
from SSA about the member’s death?
A.The last day of the month the member passed.
B.The first day following the month, the member has passed.
C.The last day of the year that the member passed.
D.The day CMS is notified, the member has passed.
E.I don't know yet
A.The last day of the month the member passed.
In which phase do you especially strive to remain engaged with the caller
and keep them informed as you follow process guidance in Mentor?
A.Resolution Phase
B.Opening Phase
C.Issue Identification Phase
D.Closing Phase
E.I don't know yet
A.Resolution Phase
What is the first thing you should do before ordering any printed materials
for a member?
A.Verify the address on file is correct.
B.View the member's account page.
C.Find records of previously printed documents.
D.Verify the member's phone number.
E.I don't know yet
A.Verify the address on file is correct.
Where would you go to view a letter a member is calling about?
A.The RTI section of CRM.
B.The ID Card Center.
C.The Find Care link.
D.The Person Account page.
E.I don't know yet
A.The RTI section of CRM.
Where in CRM do you access the template to make updates or changes
to a member's demographics?
A.Case Edit page
B.Plan Member Page
C.Person Account Page
D.QuickStart+
E.I don't know yet
A.Case Edit page
What Classification & Intent Should be selected for a grievance call?
A.The C&I that you select should match the main reason for the
call.
B.Always use the Complaints or Compliments - All Other
Complaints.
C.Always use the Complaints or Compliments - QAA.
D.Always use the Complaints or Compliments - Compliments.
E.I don't know yet
A.The C&I that you select should match the main reason for the