During an appointment, you may not discuss any products not agreed to in advance by the beneficiary.
a. True
b. False Correct Answer: True
When a paper SOA form is used, it must be completed __________ hosting the
...
During an appointment, you may not discuss any products not agreed to in advance by the beneficiary.
a. True
b. False Correct Answer: True
When a paper SOA form is used, it must be completed __________ hosting the sales presentation.
a. Prior to
b. During
c. After Correct Answer: A. Prior to
Brokers/Agents can submit a support ticket online through their Centene Workbench portal.
Select one:
True
False Correct Answer: True
Wellcare does not need to be informed of all marketing/sales events at which plans or materials will be presented or distributed (Formal & Informal).
Select one:
True
False Correct Answer: False
Which of the following actions are you required to do when contacted regarding an allegation of noncompliant activity?
a. Speak with the investigator as quickly as possible.
b. Answer all questions honestly and completely.
c. Offer information and documents important to the investigation.
d. All of the above Correct Answer: D. All of the above
Key areas you as a broker/agent have control over and impact upon regarding Star Ratings for quality are:
a. Member Satisfaction/Experience
b. Complaints
c. Rapid Disenrollment
d. All of the above Correct Answer: D. All of the above
Noting the correct enrollment period on enrollment applications helps in preventing delayed enrollment processing.
Select one:
True
False Correct Answer: True
Health plan fax numbers vary for health plans that offer fax enrollment submissions.
Select one:
True
False Correct Answer: True
Centene requires all contracted brokers/agents to read, understand, and agree to Centene's Business Ethics and Code of Conduct Policy.
Select one:
True
False Correct Answer: True
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.
a. 30
b. 45
c. 60
d. 90 Correct Answer: C. 60
Any request or distribution of PHI should contain only the minimum amount of PHI required to complete the intended task.
Select one:
True
False Correct Answer: True
Beneficiary-facing content that includes generic or plan-specific product or benefit information must be submitted for review and CMS submission, as well as acceptance or approval, prior to distribution.
Select one:
True
False Correct Answer: True
A broker/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.
Select one:
True
False Correct Answer: True
Failure to inform a beneficiary that a trusted provider is out-of-network or is not available in the newly selected plan can cause a sales allegation.
Select one:
True
False Correct Answer: True
A Health Risk Assessment (HRA) can be completed for C-SNP and D-SNP plans only, before the enrollment application process in Ascend through the Value Based Enrollment (VBE) portal.
Select one:
True
False Correct Answer: False
What are some examples of what can trigger a beneficiary complaint?
(Select all that apply.)
a. Did not consent to enroll in the plan.
b. Received incorrect plan benefit information or were dissatisfied with plan benefits.
c. Had enrollment/disenrollment issues (e.g., disenrollment/cancellation requests, late enrollment penalty, loss of entitlement).
d. Were misled about which providers were in-network. Correct Answer: All (A,B,C,D)
A broker/agent who has never had any verbal warnings cannot be issued a Corrective Action Plan.
Select one:
True
False Correct Answer: False
Prior to completing the enrollment form, you should always confirm the beneficiary's primary care physician (PCP) and/or specialists.
Select one:
True
False Correct Answer: True
The _________ plan is expected to have one of the lowest premiums in the country!
a. Classic
b. Value Plus
c. Value Script Correct Answer: C. Value script
Wellcare added ___ counties to their footprint for 2023.
a. 122
b. 209
c. 284
d. 327 Correct Answer: B. 209
The Wellcare preferred pharmacy network includes Walgreens, CVS, and many grocery chains in 2023.
Select one:
True
False Correct Answer: True
____ PDPs will be offered across all 50 U.S. states and Washington, D.C.
a. Two
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