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where do you find the questions for the member material survey
member material survey tab in salesforce
You have left a message on the members voicemail you document salesforce and close call as completed as the member will now call back
FALSE
You are told by the person answering the phone that you have the wrong number , you leave call open
FALSE
a member asks to be placed on the DO NOT CALL LIST you should leave call open to be reassigned.
FALSE CLOSE AND DOCUMENT
WHAT STATE MUST YOU ASK MEMBER TO COMPLETE MEMBER MATERIAL SURVEY
TEXAS
UNDER WHAT TAB IN SALESFORCE CAN YOU VERIFY MEMBERS PCP ASSIGNMENT?
HEALTH NOTES TAB
Which case type do you select for the IL HRA survey in SALESFORCE
RESPONDING TO MEMBER OUTREACH
Molina Health Care of TEXAS requires members to visit their PCP within __ days of signing up.
90 days
Molina Health care Medicaid members of TEXAS are auto enrolled every calendar year. TRUE/FALSE
FALSE. You are required to renew your benefits every year
You are scheduling a PCP appointment for your member. Your documentation must include the_____ and ______.
DATE and TIME of appointment.
Your member agrees to do the member material survey. Where do you document their responses to the survey questions?
‘Member Material Survey’ tab in SFL
Following the Caller Verification Grid you realize the member you are calling about is a minor. What do you do
This is < Representative’s First name> from Molina Healthcare. May I please speak to [the parent or guardian of] <Member First name>? 
Name 3 reasons we make WELCOME CALLS
Explain plan benefits*Make sure members know their PCP*Make sure welcome kit has been received. Help members pick a PCP, Offer to make PCP appointments
Does my MEDICAID ID card have my PCP name listed on it?
YES!
A member asks " Will I receive ID Cards for my dependents ?
YES Molina Medicaid of TX issues ID cards for Each Member on Plan
VISION BENEFITS are included for TEXAS MEDICAID members. TRUE/FALSE
TRUE
MEDCAID MEMBER has just moved to a new address she needs to report this to ________
state welfare office
Molina Health Care Transportation Department provide rides to active Medicaid members for PCP appointments
FALSE
Your member confirms that her PCP we have on file is correct. What is your next question to her ?
Have you had an opportunity to make an appointment to see your routine care provider?
You ask your member if they mind taking a few minutes to complete a brief HEALTH RISK ASSESSMENT and they say sure,but I dont have time . Is there somewhere else I can complete it?
MYMOLINA self service member portal
Consider the following greeting did this agent nail his opening? HI ! This is ANDY Calling from Molina Health Care of TEXAS may I speak to CLINTON BIXBY?
Only ask for your Member by their FIRST NAME. Full names are PHI.
You are making an outbound call and the member is unreachable you DOCUMENT, and close the case.
FALSE
If its NOT DOCUMENTED it________ __________!
DIDNT HAPPEN!
IN HEALTH INSURANCE WORLD A DENIAL EQUALS WHAT?
APPEAL
IN HEALTH INSURANCE WORLD A "COMPLAINT" is known as what??
GRIEVANCE
You have VERIFIED Member has a PHI Form on file for the person you are speaking with, the Caller wants to change Members PCP , CAN YOU?
NO.. Only POA or Member may change PCP on an account


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