WellCare ACT 2022 (Centene) Answered100% Correct

A grievance request, or any evidence concerning a grievance, must be filed orally or in writing no later than _____ calendar days from the date of the event or the date the member is made aware of the issue. - ANSWER 60 ...

A grievance request, or any evidence concerning a grievance, must be filed orally or in writing no later than _____ calendar days from the date of the event or the date the member is made aware of the issue. - ANSWER 60 When completing an application, you should ensure that you enter the provider ID of a specialist and not a Primary Care Physician (PCP). - ANSWER False Which of the following statements about completing telephonic enrollments is FALSE? - ANSWER Must include most of the required elements necessary to complete the enrollment A passing score of __ or higher must be achieved to successfully complete this course - ANSWER 85% To ensure accurate data entry, you should repeat the Medicare ID back to the beneficiary. - ANSWER True Steps to take when safeguarding and securing PHI and PII include - ANSWER All of the Above An agent may be terminated for cause if they fail to comply with a compliance investigation, encourage others to avoid the compliance interview process, or fail to provide truthful or complete information - ANSWER True For 2022, ______ will no longer be a preferred pharmacy - ANSWER Walmart The Part D Senior Savings Model (SSM), which reduces member spending on insulin, will be offered on the Value Script and Value Plus products - ANSWER True Communication of PHI can be: - ANSWER Written, Electronic, Verbal Agents must meet all required contracting, training, and certification requirements to be eligible to sell Wellcare's Medicare Products - ANSWER True Wellcare offers a robust portfolio of products and plans across _____ states. - ANSWER 50 When enrolling a D-SNP beneficiary, be sure to verify plan enrollment eligibility and that the MSP program level is eligible for the requested plan. - ANSWER True Wellcare's 2022 product expansion represents an 8% increase from 2021. - ANSWER True Which stage of coverage is referred to as the "donut hole" as the member is paying the most for drug coverage: - ANSWER Coverage Gap Noting the correct enrollment period on enrollment applications helps in preventing delayed enrollment processing: - ANSWER True Which of the following actions are you required to do when contacted regarding an allegation of noncompliant activity? - ANSWER All of the Above Wellcare PDP is consolidating from six plan offerings to three plan offerings for 2022. Identify the INCORRECT statement regarding the plan consolidation. - ANSWER The agent of record will not remain with the member after the consolidation. All Wellcare standalone PDP plans will have a $0 Tier 1 preferred retail and mail benefit: - ANSWER True Any request or distribution of PHI should contain only the minimum amount of PHI required to complete the intended task. - ANSWER True Wellcare offers a wide variety of Medicare products consolidated under a new Wellcare brand - ANSWER True Medicare Star Ratings and performance are at the forefront of Wellcare's quality strategy. Wellcare's quality focus consists of six drivers. Which of the following is not a Wellcare quality driver? - ANSWER Member Payments Agents may be investigated after being suspected of noncompliant activity reported throughSelect all that apply. - ANSWER Compliant tracking module, grievance, secret shop finding Wellcare has streamlined standalone PDP offerings from six plans to ___ in all 34 regions across all 50 states and D.C. - ANSWER Three plans For the 2022 plan year, which health plans will be consolidated into the Wellcare Medicare brand: - ANSWER Health Net, Fidelis Care, AllWell, 'Ohana, Trillium Advantage, WellCare Verbal permission granted to discuss plan details qualifies an authorized representative to complete an application on behalf of the beneficiary. - ANSWER False Key areas you as a Sales Agent / Broker have control over and impact upon regarding Star (Quality) Ratings are - ANSWER All of the Above Wellcare has added ____ new counties to our footprint in 2022 - ANSWER 327 Which standalone Prescription Drug Plan is best for "dual-eligible" members? - ANSWER Classic