VERIFICATION
How many pieces of information do you need to verify when someone is calling on behalf of the member?
Does a member with an Aid Category of D1 receive a MH ID card?
YES
What is the Last recording played for the member when completing an application?
Rights and responsibilities
What are the 3 states system?
MMIS, HIX, and MA21
If a member 65+ calls and needs to complete an application, where would you transfer them?
MA_TXFR_SACA_Eng (Speed dial 334)
Who can make changes to a members account without the member being present?
NAV and ARDs
Is Medicare a TPL?
Yes
What is a RFI?
Request for Information
What system would you use for a member with the agency affiliation MHO?
MA21
If a member wanted to cancel their MassHealth, where would you transfer them?
We would not transfer we would follow the Admin Closure Job aid
What are the steps to receive one time consent?
Verify info with HOH, ask permission to speak to/make changes with (blank), then you can speak to caller
What is the difference between a benefit plan vs health plan?
Benefit plan is what a member is eligible for through MH, ex. STD, CarePlus, etc. Health Plan is who the member receives their benefits from and is chosen by them, ex. Tufts Health Together, WellSense, etc.
What status and 4 reason must the document be in to be expedited?
1) NEW status
2) Pregnant, Homeless, Appt within 2 weeks, and Disaster Relief
What system would you use to see member's documents that have been sent in to MH?
My WorkSpace
If a member wants to appeal where would you transfer?
EA Specialists line (MA_TXFR_EA Specialists_Eng)
Where can you verify the child/parent relationship in Hix?
Medicaid Household Summary
Which job aid and resource would you use when a member is calling for a form to be sent out to them?
Member Escalations Tasks
and Mail Request Catalog
True or False? You as a CSR, can update a members DOB at any time
False! Name and Date of birth changes cannot be done by CSRs during or outside renewals. Transfer to MEC
What system could you check if you are unable to find a member's notice?
MyServices
An assistant from a doctor's office is calling regarding a member's coverage, where would you transfer them?
MA_Provider_Eng
Where can you verify the child/parent relationship in MA21?
Screen 3
If 3 out of 4 family member have MH Standard and 1 has Health Connector, what is this type of family called?
Mixed Household
I am 67 years old with a 9 year old granddaughter what application would I need to complete?
ACA-3
In MA21 where would you see the RFIs?
In the notices in the members account
If a member called threatening self harm and you needed to transfer to the the National Suicide Prevention Hotline, what is the number and would it be a warm or cold transfer?
1-800-273-8255 and Warm