Midterm Review
Medicaid Managed Care Quiz
Welcome to the Medicaid Managed Care Midterm Review Quiz! Test your knowledge of MAXeb processes, enrollment procedures, and recipient support to ensure that you are well-prepared for your role in assisting those navigating the Medicaid system.
In this quiz, you will:
- Answer 8 multiple-choice questions.
- Review essential concepts related to Medicaid Managed Care.
- Enhance your understanding of enrollment procedures and recipient options.
Which of the following activities in MAXeb does not require a manual Call Action and is automatically recorded by the system?
Providing general information
Referring a caller
Completing an Enrollment
Providing a Health Care Orientation (HCO) script
What Status on the Recipient screen (Summary subtab) of MAXeb tells you the enrollment is completed successfully?
Ready to Upload
Pending Assignment
Upload Pending
Upload Successful
What is the purpose of an Expedited Enrollment? Select all that apply:
To ensure pregnant women choose a plan rather than being defaulted into one.
To eliminate the need for the initial traditional Medicaid period.
To allow as many pregnant women as possible to go directly into Medicaid Managed Care.
To guarantee the pregnant woman can stay with her OB/GYN whether the doctor takes a Medicaid Managed Care plan or not.
B & C
When a Mandatory recipient asks to be disenrolled, what must you do? (Select all that apply.)
Give the Mandatory Disenrollment Education.
Provide the recipient with other options, such as changing the client's provider or plan.
Inform the client of what must be in a written disenrollment request.
Provide the caller with the appropriate address for the applicable program.
All the above
What is the appropriate "Override Reason" when completing a plan change for a one-month-old child?
HHSC Directed
No PCP selected by Client
Newborn Less Than 90 days old (Medicaid only)
None of the above
You get a call from someone stating to be a TP40, she states she applied for Medicaid but you are not able to find her in the system what would you do?
Explain that she should call back once she is approved for Medicaid.
Create a case for your caller by clicking the "Create New Pending Case" button below the search results.
Refer her to 2-1-1 to fill out an application over the phone.
Complete the "PENDING CASE" section with your caller's information and save the case.
B & D
What statement must you provide to a caller with a "Pending" case as part of the "Medicaid Managed Care for Pregnant Women (Including TP40s)" education scripting?
"All efforts will be made to expedite your enrollment, but if this is not possible, your enrollment will be effective within 15 to 45 days."
"You will be able to continue seeing your current OB/GYN , as long as you have enrolled with a medical plan that he/she takes."
"This enrollment will go into effect provided you are found eligible for Medicaid."
"Once your baby is born, he/she will be on your medical plan, until they are 90 days old."
All plan changes and enrollments become effective immediately.
True
False
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