Income And Medical Expense Policy

1.

When are income and medical expenses reviewed?

A.

Face to Face
B.

Level 2 6 month home visit
C.

Annual Reassessment
D.

Event Based Visit
E.

All of the above

Correct Answer(s)
A. Face to Face
C. Annual Reassessment
D. Event Based Visit

Explanation
Income and medical expenses are reviewed during face-to-face meetings, annual reassessments, and event-based visits. These reviews are conducted to assess the individual's financial situation and medical needs accurately. Face-to-face meetings allow for direct interaction and verification of income and expenses. Annual reassessments ensure that any changes in income or medical expenses are accounted for. Event-based visits are scheduled when there are significant changes in the individual's circumstances. By reviewing income and medical expenses through these various methods, a comprehensive evaluation can be made to determine the individual's eligibility for certain benefits or assistance programs.

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2.

If family members who live with client pay rent to the client every month, then it should be counted as income (there is no lease).

A.

True
B.

False

Correct Answer
B. False

Explanation
If family members who live with the client pay rent to the client every month, it should not be counted as income because there is no lease agreement. Without a formal lease agreement, the payments made by family members can be seen as voluntary contributions or assistance rather than rental income. Therefore, it is not appropriate to consider it as income.

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3.

Two sisters live together and are both enrolled in ESP. They deposit their social security checks into a shared checking account. The income should be counted separately and an attestation should be completed on each sister individually.

A.

True
B.

False

Correct Answer
A. True

Explanation
The explanation for the correct answer is that since the two sisters live together and are both enrolled in ESP, their income should be counted separately. This means that each sister's social security check should be considered as their individual income. Additionally, an attestation should be completed on each sister individually, further emphasizing the need to treat their income separately. Therefore, the statement "True" is correct.

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4.

The client reports he purchased a stair lift last year but does not have a receipt. Without the stair lift expense client will have a 40% copay. It is acceptable to use this medical expense on the attestation.

A.

True
B.

False

Correct Answer
B. False

Explanation
The client cannot use the stair lift expense on the attestation because he does not have a receipt. Without the receipt, there is no proof of the purchase and therefore it cannot be considered a valid medical expense.

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5.

A client lives with a spouse who IS NOT enrolled in ESP and a sister who IS enrolled in ESP. How many people need to be included on the attestation for this client?

A.

1
B.

2
C.

3
D.

None of the above

Correct Answer
B. 2

Explanation
The correct answer is 2 because the client and their sister, who is enrolled in ESP, both need to be included on the attestation. The spouse, who is not enrolled in ESP, does not need to be included.

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6.

What is the procedure for entering a client's income in Q when the client signed a waiver of income review?

A.

Enter "9999" in the "other" box on the attestation.
B.

Enter the complete amount in the appropriate category on the attestation that client verbally reports to you.
C.

No information is entered on the detail screen.
D.

Document that the client verbally agreed to 100% copay
E.

A and D

Correct Answer
E. A and D

Explanation
The correct answer is A and D. This is because when a client signs a waiver of income review, the procedure for entering their income in Q is to enter "9999" in the "other" box on the attestation and document that the client verbally agreed to 100% copay. No information is entered on the detail screen, and the complete amount is not entered in the appropriate category on the attestation as the client's income is waived.

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7.

What information needs to be entered into the income case note?

A.

The type of income medical expenses reviewed and their sources
B.

Verbal agreement to copay
C.

Client signed attestation
D.

The amount of savings client has in the bank
E.

All of the above

Correct Answer(s)
A. The type of income medical expenses reviewed and their sources
B. Verbal agreement to copay
C. Client signed attestation

Explanation
The income case note should include the type of income, medical expenses reviewed, and their sources. It should also mention the verbal agreement to copay and the client's signed attestation. All of this information is necessary to accurately document the client's income and expenses for the income case.

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8.

It is acceptable to start services for a client who has just been discharged from the hospital and is in urgent need of services but has not had a chance to get the financial information together.

A.

True
B.

False

Correct Answer
B. False

Explanation
It is not acceptable to start services for a client who has just been discharged from the hospital and is in urgent need of services but has not had a chance to get the financial information together. Financial information is a crucial aspect in determining eligibility for services and ensuring proper billing and payment arrangements. Starting services without this information may lead to complications and difficulties in obtaining payment for the services provided.

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9.

It is okay to skip the medical expense review if the client is on Medicaid?

A.

True
B.

False

Correct Answer
A. True

Explanation
The answer is true because Medicaid is a government program that provides healthcare coverage for low-income individuals and families. If a client is on Medicaid, their medical expenses are typically covered by the program. Therefore, it may not be necessary to review their medical expenses separately as they are already being taken care of by Medicaid.

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10.

A couple live together but are divorced. You count them as a couple since they live together and share the mortgage.

A.

True
B.

False

Correct Answer
B. False

Explanation
The statement is false because even though the couple live together and share the mortgage, they are divorced. Divorce legally ends the marriage, and therefore they are no longer considered a couple.

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