Final Q#5

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Final Q#5
2013-10-22 18:51:40
Rlease from hold

final review
Show Answers:

  1. When doing a release from hold you are; Processing a:
    Activating member account in MEIS
  2. A release from hold call is a type of ____ call.
    Eligibility status
  3. What does AEVS stand for?
    Automated eligibility verification system
  4. When a MediCal member's account shows terminated, the MSR rep will give eligibility based on what:
    Is shown in AEVS
  5. When looking up a member in AEVS, you verify the month the member was disenrolled first?
  6. How soon will a release form hold be updated in MEIS once the documentation was completed?
    within 24 hours
  7. What items do you look at when looking in AEVS:
    • MBR's name
    • MBR's DOB
    • Signal light
    • Message box
    • PHP
    • HCP
    • PCP
    • Aid Code
    • EVC#
  8. The member's record shows terminated on May 3, 2012; what month do you verify first in AEVS?
    Current and work your way back.
  9. Are members always placed with the doctor that is showing in AEVS? If no, explain when they may be placed with a different doctor.
    No. if the doctor is not available in MEIS, then they will be asked what provider they would like to be placed with.
  10. Once you verify the eligibility in AEVS, what is the next thing that you do?
    Find out what doctor the member was last assigned to and verify if that doctor is still active.
  11. What is placed in the "Elig info given" box when the member has a red light?
    No recorded eligibility
  12. What call type is used with this type of call?
  13. Release from hold call is not an eligibility call.
  14. What screen do you look in when verifying the availability of the PCP?
    PCP inquiry screen
  15. If a member is trying to pick up their medication and their account is showing terminated as of July 31. 2012 and AEVS shows they are active. After you complete the Release from hold, who do you send this notice to so the member can get their medication within 2 hours
  16. We can only place a member back with their previously assigned PCP when the doctor's panel shows "Y, Y"