Centene- Medicare--Final Review Questions With Correct
Answers Already Passed!!
All calls that are from providers are immediately transferred to Provider Service
after Properly documenting in Omni
a)True
b)False
True
What is the correct intent for scheduling transportation?
a) Log View Statue
b) Accumulator inquiry
c) Issues
d) Billing
a) Log View Statue
Opioid Treatment Program Services is part of Medicare Part C
a)True
b)False
b)False
You should offer cover determination - Tier Exception for the following Scenario:
What do you offer?
"My doctor recently prescribed me a medication that the pharmacy is telling me
has a copay. I can't afford that! Am I just supposed to go out the medicine my
doctor says I need?
a)True
b)False
a)True
Match with the correct States below:
a) Fax the CM referral form to 800-745-6955
b) Send a secure detailed email
c) Call 844-343-9675 and leave a detailed message on CM line or send a secure
detailed email
1.__________ Arizona
2._________ California
3._________ Oregon
1. C Arizona
2. A California
3. B Oregon
Change payment method intent is used:
a) Used to schedule transportation
b) Used to add, remove, or modify credit card information to automatically pay a
premium.
c) Used to request authorization
d) Used to add AOR
b) Used to add, remove, or modify credit card information to automatically pay a
premium.
, TAT for the prior Authorization request for urgent requests
a) 24-36 hours
b) Same day
c) 5 business days
d) 24-72 hours
d) 24-72 hours
All of the Centene HealthNet and All Well have plans that are PPOs
a) True
b) False
b)False
You must not document via Member not found if the member was not located in
Omni?
a) True
b) False
b)False
"I feel depress and worthless' is an example of Behavior Health Crisis Calls
a) True
b) False
a)True
"I think it would be the best for everyone if I was around anymore" is an example
of Behavior Health Crisis Calls
a) True
b) False
a)True
You can verify Member's Eligibility in Portico
a) True
b) False
b)False
World-wide coverage is offered by all Centene plans
a) True
b) False
b)False
If address that reflects in MARx is different than the one in Omni we would
a) Apologize for the inconvenience and ask them to contact SSA to make the
address change
b) Submit the address change request
c) Send an update address request via Log View Status to Misc enrollment
issues.
d) Submit the address change request and direct the member to contact the
social Security Admin to update their address with them
d) Submit the address change request and direct the member to contact the social
Security Admin to update their address with them
I cannot talk to a member with TTY operator on the line because it is a violation of
HIPAA
a) True
b) False
Answers Already Passed!!
All calls that are from providers are immediately transferred to Provider Service
after Properly documenting in Omni
a)True
b)False
True
What is the correct intent for scheduling transportation?
a) Log View Statue
b) Accumulator inquiry
c) Issues
d) Billing
a) Log View Statue
Opioid Treatment Program Services is part of Medicare Part C
a)True
b)False
b)False
You should offer cover determination - Tier Exception for the following Scenario:
What do you offer?
"My doctor recently prescribed me a medication that the pharmacy is telling me
has a copay. I can't afford that! Am I just supposed to go out the medicine my
doctor says I need?
a)True
b)False
a)True
Match with the correct States below:
a) Fax the CM referral form to 800-745-6955
b) Send a secure detailed email
c) Call 844-343-9675 and leave a detailed message on CM line or send a secure
detailed email
1.__________ Arizona
2._________ California
3._________ Oregon
1. C Arizona
2. A California
3. B Oregon
Change payment method intent is used:
a) Used to schedule transportation
b) Used to add, remove, or modify credit card information to automatically pay a
premium.
c) Used to request authorization
d) Used to add AOR
b) Used to add, remove, or modify credit card information to automatically pay a
premium.
, TAT for the prior Authorization request for urgent requests
a) 24-36 hours
b) Same day
c) 5 business days
d) 24-72 hours
d) 24-72 hours
All of the Centene HealthNet and All Well have plans that are PPOs
a) True
b) False
b)False
You must not document via Member not found if the member was not located in
Omni?
a) True
b) False
b)False
"I feel depress and worthless' is an example of Behavior Health Crisis Calls
a) True
b) False
a)True
"I think it would be the best for everyone if I was around anymore" is an example
of Behavior Health Crisis Calls
a) True
b) False
a)True
You can verify Member's Eligibility in Portico
a) True
b) False
b)False
World-wide coverage is offered by all Centene plans
a) True
b) False
b)False
If address that reflects in MARx is different than the one in Omni we would
a) Apologize for the inconvenience and ask them to contact SSA to make the
address change
b) Submit the address change request
c) Send an update address request via Log View Status to Misc enrollment
issues.
d) Submit the address change request and direct the member to contact the
social Security Admin to update their address with them
d) Submit the address change request and direct the member to contact the social
Security Admin to update their address with them
I cannot talk to a member with TTY operator on the line because it is a violation of
HIPAA
a) True
b) False
