2014-qm Fun Quiz 1
This is the funnest quiz ever!
- 1.
Call ID 7136839. Timestamp 00:12:00 - 00:13:10. What did the BA say that was incorrect?
- 2.
The ADP read a non-required benefit incorrectly. How would you grade it?
- A.
Mark as a minor on the QM form
- B.
Since there is nowhere to grade it, coach it
- C.
Mark as major on the QM form
- D.
Red Flag
Correct Answer
A. Mark as a minor on the QM formExplanation
The correct answer is "Mark as a minor on the QM form." This is because the ADP (Automated Data Processing) read a non-required benefit incorrectly, which is a minor issue. Therefore, it should be marked as a minor on the Quality Management (QM) form to indicate that it is a small error that does not have a significant impact.Rate this question:
-
- 3.
The customers are each enrolling into the same MAPD plan. Select what must be done on a joint application. Check ALL that apply.
- A.
Read the opening script twice-once to each customer
- B.
Authorize each other to assist with the application, number 10 in the Definitions
- C.
Read the long term care facility tiers for drug coverage
- D.
Get a response from each customer on number 9
Correct Answer(s)
B. Authorize each other to assist with the application, number 10 in the Definitions
D. Get a response from each customer on number 9Explanation
On a joint application for enrolling into the same MAPD plan, it is necessary to authorize each other to assist with the application, as mentioned in number 10 of the Definitions. Additionally, it is important to get a response from each customer on number 9.Rate this question:
-
- 4.
Since the customers are HIPAA reps for each other, MR can answer for MRS on number 4 in the script
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
The statement suggests that MR can answer for MRS on number 4 in the script. However, without any context or additional information, it is not clear what "MR" and "MRS" refer to, or what "number 4 in the script" means. Therefore, it is not possible to provide a clear explanation for why the answer is false.Rate this question:
-
- 5.
The ADP read all of the benefits verbatim, but did not read the headers for Doctor and Hospital Choice or Emergency Care. What grade would you give for those line items?
- A.
Yes
- B.
Minor
- C.
Major
- D.
Red Flag
- E.
Coach
Correct Answer
A. YesExplanation
The given answer "Yes" suggests that the ADP did read the headers for Doctor and Hospital Choice or Emergency Care. This indicates that the ADP correctly understood and acknowledged these line items.Rate this question:
-
- 6.
Call ID 7150253. Timestamp 00:03:27-00:04:20. Grade number 3 on the QM form.
- A.
Prohibited Practice
- B.
Coach
- C.
Red Flag because the BA said 'typically'
Correct Answer
A. Prohibited Practice -
- 7.
Call ID 7191059. Grade Secure the Call for the BA.
- A.
Yes
- B.
Major
- C.
N/A
- D.
Red Flag
Correct Answer
C. N/AExplanation
This should be marked N/A and a coaching note could be added. The BA does not need to re-secure the call when it is an internal transfer.Rate this question:
-
- 8.
Call ID 6990939. Timestamp 00:07:50 - 00:08:06 What prohibited practice would you use for this?
- A.
Make any statement, claim or promise that conflicts with, alters or erroneously expands upon the information contained within CMS-approved materials, this includes misquoting plan benefits
- B.
Claiming that a specific carrier is recommended or endorsed by CMS, Medicare or the Department of Health and Human Services
- C.
Use absolute superlatives like asserting that a certain plan is “the best” plan
- D.
Mislead, confuse or misrepresent to potential members about Medicare or competitive plans
Correct Answer
C. Use absolute superlatives like asserting that a certain plan is “the best” planExplanation
The prohibited practice in this case would be using absolute superlatives, such as asserting that a certain plan is "the best" plan. This is because it is not allowed to make exaggerated claims or use language that implies superiority or exclusivity when describing a plan. Doing so could mislead or confuse potential members about the actual benefits and options available to them.Rate this question:
-
- 9.
The customer chose a Medigap Plan N and a Humana PDP. When the BA was transferring the call to an ADP, the line disconnected. The BA noticed that the Medigap plan for some reason, was not in the cart anymore, but the PDP was still there. The BA told the customer to hold on while she put the Medigap plan back in the cart. After she put the plan in the cart again, she transferred the call to an ADP. Since the BA only needed to put one of the plans back in the cart, the BA didn't have to read the MIR.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
Any time the BA has to put a plan in the cart, the MIR must be read.Rate this question:
-
- 10.
The HIPAA called in for the customer and secured the call. 30 minutes later the customer came on the line. The BA secured the call with the customer. The customer could not recall the last four digits of their SSN and gave the incorrect phone number. How would you score Secure the Call?
- A.
Yes
- B.
Major
- C.
N/A
- D.
Red Flag
Correct Answer
A. YesExplanation
The HIPAA already secured the account, so the BA did not need to go through STC with the customer.Rate this question:
-
Quiz Review Timeline +
Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.
-
Current Version
-
Jan 09, 2023Quiz Edited by
ProProfs Editorial Team -
Jan 02, 2014Quiz Created by
Bthorup
Back to top