Show:
eligibility & enrollment
Benefits
All about CareSource
Random
Provider/complaints
100

who determines members eligibility 

when does this plan become effective

the state

01/01/2026

100

Does NV cover hearing benefits?

If so are their any limitations?

Who handles it?

yes covered

1 every 12 rolling months

nations





100


what does ACW stand for?

what does AHT stand for?

after call work

average handle time

100

when was CareSource founded

  • Founded in 1989, CareSource administers one of the largest Medicaid managed care plans in the U.S.




100

DME stands for what

Durable medical equipment

200

ELIGIBLE / UNAWARE THEY WERE PLACED ON CARESOURCE: what do you do?

  • ADVISE: that member eligibility is determined by the Nevada Department of Health and Human Services.
  • ADVISE: that when a person becomes eligible for Medicaid, the state sends them a letter asking them to choose a plan. If no plan is selected, they will be automatically assigned to a plan.
  • DOCUMENT the details of the call in the Case Notes.
200
  • Psychotherapy/Counseling
  • Hormonal Therapy (pharmacy) 
  • Gender Affirming Surgery

are they covered? Do they need a PA? 

covered PA needed


200
what is the CareSource mascot?

and what is their name?

bear

cuddles


200

How many members do we serve in OH Medicaid

1,052,806

200

what two resources can you use to find providers?

365/FAD

300

 How long does it take for future members profile to show in our system?

  • Future member profiles generally post in Dynamics within five days of the effective date.
300

what is the name of the interpreter services we use (the main one). Also provide their phone number and access code

How long do you wait for someone until you call the next interpreter service

Language line. 800-523-1786. 683.


2 mins

300

Every year in March the company gives out their AIP bonus to eligible employees.

what is the eligibility requirements 

An Eligible Employee is an employee of the Company who: 1) is employed with the Company on the Payment Date (defined below), including those on a Company approved leave of absence; 2) has a date of hire, based upon the most recent date in the HR system, that was prior to October 1st of the AIP Year; and 3) is in good standing with the Company during the AIP Year and on the Payment Date.

300

How long do they advise you have to be here before upskilling in another line of business?


How long do they advised you have to be here before applying to other departments

6 months

12 months

300

A provider sent over a PA for a member to get a power wheelchair

what system do you use to check the status of this and what KA 

guiding care

KA-01061




400

member calls in to check their eligibility- you notice they are active but have a termination date, what do you do?

  1. ADVISE: the member is showing eligible with CareSource as of (date), but there is a termination date of (date) on file. Eligibility is determined by the Nevada Department of Health and Human Services.
  2. ADVISE: the member to speak with a case worker for more information about future eligibility.
400

what is the kids program

Community centers and organizations offering community activities have the potential to be a “hub” of health, education, well-being programs, and community engagement. CareSource will cover cost of a single enrollment fees with Boys and Girls Club.

400

As an employee CareSource offers Discounted tickets to places. name 3

any 3 is fine 


400

How long is ACW

what is SL meaning

what is ASA meaning

after call work- 1.30

sl= service levels

ASA= average speed of answer

400

random question: 

how many lines of business am I trained in?

4

500

when ordering an ID card for a member- you must always ask what?

 

If their pcp is correct 

500
what two things must you have up when going over benefits with members

Benefit grid and PA list

500

what is CareSource's Mission, vision and values.

Our Mission

To make a lasting difference in our members’ lives by improving their health and well-being.


Our Vision

Transforming lives through innovative health and life services.


Our Values


  • We value our employees
  • We live the mission
  • We drive innovation through learning and continuous improvement
  • We demonstrate accountability to deliver results
  • We collaborate to support a matrix environment


500

How many questions is the survey at the end of the call

3

500

A member needs to see a specialist but there are none within 50 miles, and we can not locate any. This causes what

access issue