Which statement below accurately describes MassHealth? - ANSWER Medicaid for those in Massachusetts
Which of the following is an eligibility requirement for MassHealth Standard? - ANSWER Resident of the state of Massa
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Which statement below accurately describes MassHealth? - ANSWER Medicaid for those in Massachusetts
Which of the following is an eligibility requirement for MassHealth Standard? - ANSWER Resident of the state of Massachusetts
Which of the following components of the UnitedHealthcare SCO Plan is considered its foundation? - ANSWER Care Management
Which of the following is not a key component of the UnitedHealthcare SCO care management program? - ANSWER Standardized care plan that fits all consumers
When does plan coverage begin for a new UnitedHealthcare SCO member? - ANSWER First of the month following the date a complete enrollment application was received by the agent, (i.e. plan receipt date)
Which of the following questions could you ask the consumer to help determine if they are enrolled in PACE or another SCO plan? - ANSWER Do you attend an Adult Day Health (ADH) program a regular basis?
Which of the following is an eligibility requirement to enroll in the UnitedHealthcare SCO plan? - ANSWER Resident of the plan service area
Which of the following is a reason to avoid enrolling PACE members in UnitedHealthcare SCO? - ANSWER These members are very frail and moving to SCO would disenroll them from their PACE plan and change their providers and care approach.
Which of the following statements best describes UnitedHealthcare SCO plan Primary Care Provider (PCP) requirements? - ANSWER The consumer's PCP must be in the plan's contracted network or the consumer must select a PCP who is.
Why does the Care Management Team use the Health Risk Assessment Tool? - ANSWER To assess the level of each member's health care needs
If coverage guidelines are met, which one of the following is not typically included in Community Services? - ANSWER Pet grooming
Select which group of individuals might qualify for Medicaid. - ANSWER Certain persons and families with low-income
Which of the following components of the UnitedHealthcare SCO Plan integrates all other components into a seamless model of care? - ANSWER Care Management
What is the purpose of UnitedHealthcare SCO plan's care management program? - ANSWER Care Management helps to proactively coordinate and integrate services into one seamless model of care.
When will Mary's coverage begin if she completes her UnitedHealthcare SCO enrollment application on May 20? Note: Mary has Medicaid and Medicare and has not used her Dual/LIS Maintaining SEP for quarter 2. - ANSWER June 1
Agent John is meeting with consumer Natalie and determines she is not eligible to enroll in the UnitedHealthcare SCO plan. Select from the following the reason why she is not eligible. - ANSWER She has Original Medicare only
Which of the following makes it generally inappropriate to enroll members of the PACE program into a SCO plan? - ANSWER They are very frail and moving to SCO would disenroll them from their PACE plan and change their care approach.
What tool is used by the UnitedHealthcare SCO team to assess the level of each member's health care needs? - ANSWER Health Risk Assessment Tool
If coverage guidelines are met, which one of the following is typically included in Community Services? - ANSWER Housekeeping
While determining if Carl is eligible for the UnitedHealthcare SCO plan, Anne learns that Carl does not pay any copayments when he goes to the pharmacy. What might this indicate? - ANSWER Carl may be enrolled in a PACE program or another SCO. If that is confirmed, he should not be enrolled in UnitedHealthcare SCO unless he fully understands the enrollment will disenroll him from PACE plan and change his providers and care approach.
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