2014 - Qm - Opening Script
This 2014 - QM - Opening Script quiz assesses understanding of compliance protocols in healthcare, focusing on HIPAA, recording consent, and proper agent responses. It prepares participants for handling sensitive information and obtaining necessary permissions in professional scenarios.
- 1.
How would you grade the following statement and why?"My name is Fi Schneider, today is Wednesday July 14th. This call will be recorded- do I have your permission to record this conversation to confirm your enrollment?"
- A.
Yes- There is nothing wrong with the statement.
- B.
Minor- The BA/ADP did not read the statement verbatim (the year was not stated)
- C.
Major-The BA/ADP skipped part of the statement (the year was not stated)
Correct Answer
B. Minor- The BA/ADP did not read the statement verbatim (the year was not stated)Explanation
The script was not verbatim. The agent left out the year.Rate this question:
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- 2.
The HIPAA statement/question must be read/asked on every application.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
If the customer is the only person on the line, then the HIPAA statement/question does not need to be read/asked.Rate this question:
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- 3.
Mr. Smith is completing the enrollment both for himself and his wife, for whom he has Power of Attorney. When asked "Are you completing this Medicare enrollment for yourself?", Mr. Smith replies "Yes" and the ADP moves on to the next section. Did the ADP obtain the proper response?
- A.
No- the ADP only obtained a response regarding Mr. Smith's application.
- B.
No- the answer should be "no" since the customer is completing the enrollment for his spouse.
- C.
Yes.
Correct Answer
A. No- the ADP only obtained a response regarding Mr. Smith's application.Explanation
If a customer is completing an application for themselves as well as a spouse, then the question must be asked for each customer and the proper response obtained.Rate this question:
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- 4.
On which applications must the MIR be read?(Hint: This refers to the MIR in the Opening Script, not the MIR that is read before quoting plans)Select all that apply.
- A.
Medigap-GI
- B.
Cost plan
- C.
Vision plan
- D.
Medigap-Underwritten
- E.
Medicare Advantage plan
- F.
Dental plan
- G.
Prescription Drug plan
Correct Answer(s)
A. Medigap-GI
B. Cost plan
E. Medicare Advantage plan
G. Prescription Drug planExplanation
Underwritten applications do not require the MIR as the customer is subject to medical underwriting questions that must be answered.
Additionally, we do not monitor Dental or Vision plan enrollments.Rate this question:
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- 5.
A friend, or relative, that is a sales agent or broker cannot assist the customer with their enrollment.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
Provided that the friend/relative is not functioning in a sales agent or broker capacity, they can remain on the line and assist the customer as their HIPAA representative.Rate this question:
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- 6.
The BA/ADP asks for permission to record the conversation on a joint application- Mr. Wayne says "Yes you do.", however Mrs. Wayne says nothing. How should this be graded?
- A.
Yes.
- B.
Major- The BA/ADP skipped this line completely.
- C.
Minor- The ADP/BA did not obtain consent to record the call.
Correct Answer
C. Minor- The ADP/BA did not obtain consent to record the call.Explanation
On a joint application, both customers must give verbal consent to record the conversation. This would not be considered a major infraction as the question wasn't skipped, it was asked but wasn't answered by both parties.Rate this question:
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- 7.
The BA/ADP did not read the plan number when summarizing the enrollment decision- this should be marked as a minor infraction for not reading the script verbatim.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
The plan number (S7654-321) does not need to be read when summarizing the enrollment.Rate this question:
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- 8.
On a joint application, the BA/ADP is required to:
- A.
A- Obtain a verbal response to the HIPAA question from each customer.
- B.
B- Read the entire opening script twice, once to each customer.
- C.
C- Provide the average of the two premiums if they are different for each customer.
- D.
D- Both B and C.
- E.
None of the above.
Correct Answer
A. A- Obtain a verbal response to the HIPAA question from each customer. -
- 9.
Dr. Grey has Power of Attorney for her husband, however he will be completing his own enrollment with assistance from his wife. The BA/ADP must ask the POA question/ read the POA statement to Dr. Grey and obtain verbal confirmation that she holds Power of Attorney.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
Since Dr. Grey is not functioning as POA during the enrollment, the BA/ADP would need only to read the HIPAA scripting and obtain the customer's consent for his wife to assist him with his enrollment.Rate this question:
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- 10.
If the POA started the application (The customer was not on the line during the Opening Script) and the customer completes it by giving their voice signature after the disclaimer, what line items on the QM form should be marked down?
- A.
3-10 only
- B.
6-10 only
- C.
9 only
- D.
53 only
- E.
We would only coach this
Correct Answer
A. 3-10 onlyExplanation
If POA starts the application, but the Customer gives the voice signature, score numbers 3-10 as if the Customer was completing the application themselves (or vice versa).Rate this question:
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Current Version
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Mar 21, 2023Quiz Edited by
ProProfs Editorial Team -
Jul 11, 2014Quiz Created by
Bthorup
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