2022 AHIP
A client wants to give you an enrollment application on October 1 before the beginning
of the Annual Election Period because he is leaving on vacation for two weeks and does
not want to forget about turning
...
2022 AHIP
A client wants to give you an enrollment application on October 1 before the beginning
of the Annual Election Period because he is leaving on vacation for two weeks and does
not want to forget about turning it in. What should you tell him? - Answer You must tell
him you are not permitted to take the form. If he sends the form directly to the plan, the
plan will process the enrollment on the day the Annual Election Period begins.
A Medicare beneficiary has walked into your office and requested that you sit down with
her and discuss her options under the Medicare Advantage program. Before engaging
in such a discussion, what should you do? - Answer You must have her sign a scope of
appointment form, indicating which products she wishes to discuss. You may then
proceed with the discussion.
A Medicare beneficiary has walked into your office and requested that you sit down with
her and discuss her options under the Medicare Advantage program. Before engaging
in such a discussion, what should you do? - Answer You must have her sign a scope of
appointment form, indicating which products she wishes to discuss. You may then
proceed with the discussion.
A person drops off a prescription for a beneficiary who is a "regular" customer. The
prescription is for a controlled substance with a quantity of 160. This beneficiary
normally receives a quantity of 60, not 160. You review the prescription and have
concerns about possible forgery. What is your next step? - Answer Call the prescriber to
verify the quantity
A sales agent, employed by the Sponsor's first-tier, downstream, or related entity (FDR),
submitted an application for processing and requested two things: 1) to back-date the
enrollment date by one month, and 2) to waive all monthly premiums for the beneficiary.
What should you do? - Answer Process the application properly (without the requested
revisions)—inform your supervisor and the compliance officer about the sales agent's
request
ABC is a Medicare Advantage (MA) plan sponsor. It would like to use its enrollees'
information to market non-health related products such as life insurance and annuities.
Which statement best describes ABC's obligation to its enrollees regarding marketing
such products? - Answer It must obtain a HIPAA complaint authorization from an
enrollee that indicates the plan or plan sponsor may use their information for marketing
purposes.
Abuse involves payment for items or services when there is no legal entitlement to that
payment and the provider has not knowingly or intentionally misrepresented facts to
obtain payment. - Answer True
ACA Section 1557 rules for disability concern - Answer Policies and procedures,
physical access, and communication.
Agent Armstrong is employed by XYZ Agency, which is under co
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