MLTC pop quiz

Provider calls to inquire on the reason for a denied claim. Which Tab in Casetrakker can you confirm if the provider was authorized to provide the denied service?
Authorizations
Letters & Attachments
Member Contacts
Member File
Members granddaughter Janice called requesting additional hha hours for member; as members health condition has changed. Jane is requesting member receive 5 days/ 8 hours each day as member is in the hospital due to a stroke and will be returning home soon. MSR will call or send an email to the :
Social Work dept.
Field Assessor
Care Coordinator
Care Manager
Members granddaughter Jane Doe, called requesting additional hha hours for member; as members health condition has changed. Jane is requesting member receive 5 days/ 8 hours each day as member is in the hospital due to a stroke and will be returning home soon. What is the activity detail in CaseTrakker?
Customer care - general inbound
SW inquiry
Customer care - care manager services
Customer care- sw inquiry
Prospect Calls to Reschedule UAS Assessment. Where in CaseTrakker can an MSR confirm there is an already scheduled UAS assessment?
JOURNAL & MEMBER FILE
JOURNAL & AUTHORIZATIONS
JOURNAL & MEMBER CONTACTS
JOURNAL & LETTERS & ATTACHMENTS
JOURNAL & ASSESSMENTS
Ms Lopez calls to inform she is back from vacation and would like her aide to come back tomorrow. MSR should send an email to [blank]
Provider calls because they received an authorization to start Home Care services on 04/15/18 for 20 hours a week but the plan of care is 22 hours a week. MSR should contact :
CM
UM
Enrollment
Field assessor
Members Daughter Calls & Request Services for A Family Member to Take Care of Her Mom.Who should MSR send an email to :
Care Manager
Clinical Team Manager
Social Work dept.
Intake UAS Nurse
Intake CDPAP
Intake Coordinator
CDPAP dept.
MBRS DAUGHTER CALLED TO ADVISE MBR WILL BE ENROLLED INTO CPHL IN 2 WEEKS BUT RECEIVED A LETTER ADVISING MBR WILL BE ASSIGNED TO CARING HOME CARE. MBR WISHES TO STAY WITH SAME AGENCY SHE HAS NOW, WHITE GLOVE. MSR SHOULD CONTACT THE CARE MANAGER
True
False
Intake UAS Nurse
Process Referrals
Assist with PCA aide replacements
Sends Authorizations to Vendor
Visits after Interruption of Care
Prospect rejection List
Clinical Needs/Change/Request for New Services
Medicaid Surplus/Renewal
Field Assessor Visits
Assist with DOH, CFEEC evaluation, MQ11 forms
Applying for SNAP benefits
Processes Claims
UAS Appointments
UAS Assessments
Intake Representative
Process Referrals
Assist with PCA aide replacements
Sends Authorizations to Vendor
Visits after Interruption of Care
Prospect rejection List
Clinical Needs/Change/Request for New Services
Medicaid Surplus/Renewal
Field Assessor Visits
Assist with DOH, CFEEC evaluation, MQ11 forms
Applying for SNAP benefits
Processes Claims
UAS Appointments
UAS Assessments
Care Manager
Process Referrals
Assist with PCA aide replacements
Sends Authorizations to Vendor
Visits after Interruption of Care
Prospect rejection List
Clinical Needs/Change/Request for New Services
Medicaid Surplus/Renewal
Field Assessor Visits
Assist with DOH, CFEEC evaluation, MQ11 forms
Applying for SNAP benefits
Processes Claims
UAS Appointments
UAS Assessments
Social Worker
Process Referrals
Assist with PCA aide replacements
Sends Authorizations to Vendor
Visits after Interruption of Care
Prospect rejection List
Clinical Needs/Change/Request for New Services
Medicaid Surplus/Renewal
Field Assessor Visits
Assist with DOH, CFEEC evaluation, MQ11 forms
Applying for SNAP benefits
Processes Claims
UAS Appointments
UAS Assessments
Member Services Representative
Process Referrals
Assist with PCA aide replacements
Sends Authorizations to Vendor
Visits after Interruption of Care
Prospect rejection List
Clinical Needs/Change/Request for New Services
Medicaid Surplus/Renewal
Field Assessor Visits
Assist with DOH, CFEEC evaluation, MQ11 forms
Applying for SNAP benefits
Processes Claims
UAS Appointments
UAS Assessments
Intake Coordinator
Process Referrals
Assist with PCA aide replacements
Sends Authorizations to Vendor
Visits after Interruption of Care
Prospect rejection List
Clinical Needs/Change/Request for New Services
Medicaid Surplus/Renewal
Field Assessor Visits
Assist with DOH, CFEEC evaluation, MQ11 forms
Applying for SNAP benefits
Processes Claims
UAS Appointments
UAS Assessments
Enrollment
Process Referrals
Assist with PCA aide replacements
Sends Authorizations to Vendor
Visits after Interruption of Care
Prospect rejection List
Clinical Needs/Change/Request for New Services
Medicaid Surplus/Renewal
Field Assessor Visits
Assist with DOH, CFEEC evaluation, MQ11 forms
Applying for SNAP benefits
Processes Claims
UAS Appointments
UAS Assessments
FHS
Process Referrals
Assist with PCA aide replacements
Sends Authorizations to Vendor
Visits after Interruption of Care
Prospect rejection List
Clinical Needs/Change/Request for New Services
Medicaid Surplus/Renewal
Field Assessor Visits
Assist with DOH, CFEEC evaluation, MQ11 forms
Applying for SNAP benefits
Processes Claims
UAS Appointments
UAS Assessments
Care Coordinator
Process Referrals
Assist with PCA aide replacements
Sends Authorizations to Vendor
Visits after Interruption of Care
Prospect rejection List
Clinical Needs/Change/Request for New Services
Medicaid Surplus/Renewal
Field Assessor Visits
Assist with DOH, CFEEC evaluation, MQ11 forms
Applying for SNAP benefits
Processes Claims
UAS Appointments
UAS Assessments
Field Assessor
Process Referrals
Assist with PCA aide replacements
Sends Authorizations to Vendor
Visits after Interruption of Care
Prospect rejection List
Clinical Needs/Change/Request for New Services
Medicaid Surplus/Renewal
Field Assessor Visits
Assist with DOH, CFEEC evaluation, MQ11 forms
Applying for SNAP benefits
Processes Claims
UAS Appointments
UAS Assessments
UM Representative
Process Referrals
Assist with PCA aide replacements
Sends Authorizations to Vendor
Visits after Interruption of Care
Prospect rejection List
Clinical Needs/Change/Request for New Services
Medicaid Surplus/Renewal
Field Assessor Visits
Assist with DOH, CFEEC evaluation, MQ11 forms
Applying for SNAP benefits
Processes Claims
UAS Appointments
UAS Assessments
Relay Health
Process Referrals
Assist with PCA aide replacements
Sends Authorizations to Vendor
Visits after Interruption of Care
Prospect rejection List
Clinical Needs/Change/Request for New Services
Medicaid Surplus/Renewal
Field Assessor Visits
Assist with DOH, CFEEC evaluation, MQ11 forms
Applying for SNAP benefits
Processes Claims
UAS Appointments
UAS Assessments
Member Satisfaction
Process Referrals
Assist with PCA aide replacements
Sends Authorizations to Vendor
Visits after Interruption of Care
Prospect rejection List
Clinical Needs/Change/Request for New Services
Medicaid Surplus/Renewal
Field Assessor Visits
Assist with DOH, CFEEC evaluation, MQ11 forms
Applying for SNAP benefits
Processes Claims
UAS Appointments
UAS Assessments
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