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A member calls Customer Service to ask benefit questions. During the conversation, the member mentions they haven't had an appetite lately because they are depressed. How would you handle the call?
True
True
3 business days
Transfer the member to Behavioral Health
Benefits Inquiry
Refer her to local Medicaid office
CMS 1696
September 1
Members are able to file a grievance by mail, fax or phone.
True
True
3 business days
Transfer the member to Behavioral Health
Benefits Inquiry
Refer her to local Medicaid office
CMS 1696
September 1
Bob is calling to change his PCP. He does not qualify for an exception but he still wants his PCP changed. Today is the 12th of August. What day will the PCP change take effect?
True
True
3 business days
Transfer the member to Behavioral Health
Benefits Inquiry
Refer her to local Medicaid office
CMS 1696
September 1
What is the timeframe for WellCare to respond to an expedited appeal request from an Iowa member?
True
True
3 business days
Transfer the member to Behavioral Health
Benefits Inquiry
Refer her to local Medicaid office
CMS 1696
September 1
As a Customer Service Representative, you are required to check the system to determine if the caller has legal authorization to act on behalf of a Member.
True
True
3 business days
Transfer the member to Behavioral Health
Benefits Inquiry
Refer her to local Medicaid office
CMS 1696
September 1
What call driver should be used when submitting a request to have a Portuguese translator present for a member’s doctor appointment?
True
True
3 business days
Transfer the member to Behavioral Health
Benefits Inquiry
Refer her to local Medicaid office
CMS 1696
September 1
Ms. Clark calls WellCare Customer Service. She is expecting her first child and was recently laid off from her job. She previously had medical insurance through her employer. What will you tell her?
True
True
3 business days
Transfer the member to Behavioral Health
Benefits Inquiry
Refer her to local Medicaid office
CMS 1696
September 1
The CMS Appointment of Representative (AOR) form is also known as what?
True
True
3 business days
Transfer the member to Behavioral Health
Benefits Inquiry
Refer her to local Medicaid office
CMS 1696
September 1
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