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2023 UHC United HealthCare - Ethics and Compliance Test Bundle
2023 UHC United HealthCare - Ethics and Compliance
[Show more]2023 UHC United HealthCare - Ethics and Compliance
[Show more]Agent John is planning to conduct a series of events. Some will be strictly educational, others will be formal presentations of specific UnitedHealthcare plans, and others will be informal marketing events where he can generate leads and schedule future in-home marketing appointments. Of the three t...
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Add to cartAgent John is planning to conduct a series of events. Some will be strictly educational, others will be formal presentations of specific UnitedHealthcare plans, and others will be informal marketing events where he can generate leads and schedule future in-home marketing appointments. Of the three t...
In terms of events, which of the following is true? - WRONG - Agents must report formal marketing/sales events only to UnitedHealthcare 
 
When completing an enrollment application in LEAN, why is an agent prohibited from entering their own email address in a field available for the consumer's e...
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Add to cartIn terms of events, which of the following is true? - WRONG - Agents must report formal marketing/sales events only to UnitedHealthcare 
 
When completing an enrollment application in LEAN, why is an agent prohibited from entering their own email address in a field available for the consumer's e...
What is a servicing agent? - an inactive, nonemployee who has signed a servicing agreement in order to receive renewal commisions on medicare advantage and prescription drug plan enrollments on or after 1-1-2014. the agent must maintain an active resident license and appointment and pass medicare...
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Add to cartWhat is a servicing agent? - an inactive, nonemployee who has signed a servicing agreement in order to receive renewal commisions on medicare advantage and prescription drug plan enrollments on or after 1-1-2014. the agent must maintain an active resident license and appointment and pass medicare...
Gene got Medicare before he turned 65 and enrolled into a Medicare Advantage plan. He calls in February the month before his 65th birthday and is unhappy with his current plan. On the date of the call, what can Gene do about his coverage? - On the day he called, he can enroll in a different Medic...
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Add to cartGene got Medicare before he turned 65 and enrolled into a Medicare Advantage plan. He calls in February the month before his 65th birthday and is unhappy with his current plan. On the date of the call, what can Gene do about his coverage? - On the day he called, he can enroll in a different Medic...
What type of events must an agent report to UnitedHealthcare? - Only the marketing/sales events, both formal and informal. 
 
While using LEAN to complete an enrollment application with a consumer, Agent Jeff learns the consumer does not have an email address. What should Jeff do? - Leave any ...
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Add to cartWhat type of events must an agent report to UnitedHealthcare? - Only the marketing/sales events, both formal and informal. 
 
While using LEAN to complete an enrollment application with a consumer, Agent Jeff learns the consumer does not have an email address. What should Jeff do? - Leave any ...
Gene got Medicare before he turned 65 and enrolled into a Medicare Advantage plan. He calls in February the month before his 65th birthday and is unhappy with his current plan. On the date of the call, what can Gene do about his coverage? - On the day he called, he can enroll in a different Medic...
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Add to cartGene got Medicare before he turned 65 and enrolled into a Medicare Advantage plan. He calls in February the month before his 65th birthday and is unhappy with his current plan. On the date of the call, what can Gene do about his coverage? - On the day he called, he can enroll in a different Medic...
reporting all events (marketing/sales and educational) to united health care is required so that the company can: - Comply with CMS and medicaid services event reporting 
 
You have a scheduled appointment with a consumer to discuss DSNP. They have the SOA form. 2 days before the appointment they...
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Add to cartreporting all events (marketing/sales and educational) to united health care is required so that the company can: - Comply with CMS and medicaid services event reporting 
 
You have a scheduled appointment with a consumer to discuss DSNP. They have the SOA form. 2 days before the appointment they...
What is the CMS-adopted NFPA standard for portable fire extinguishers? - NFPA 10 
 
2010 Edition 
 
What is the CMS-adopted NFPA National Electric Code? - NFPA 70 
 
2011 Edition 
 
What is the CMS-adopted NFPA standard for a health care facilities code? - NFPA 99 
 
2012 Edition 
 
What is...
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Add to cartWhat is the CMS-adopted NFPA standard for portable fire extinguishers? - NFPA 10 
 
2010 Edition 
 
What is the CMS-adopted NFPA National Electric Code? - NFPA 70 
 
2011 Edition 
 
What is the CMS-adopted NFPA standard for a health care facilities code? - NFPA 99 
 
2012 Edition 
 
What is...
Medicare - Federal health insurance program 
 
Medicare is administered by whom? - CMS ( Centers for medicare and medicaid services) 
 
Parts A & B of medicare are - federal health insurance program referred to as original medicare 
 
Part A? - Hospital insurance 
 
Part B? - Medical ...
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Add to cartMedicare - Federal health insurance program 
 
Medicare is administered by whom? - CMS ( Centers for medicare and medicaid services) 
 
Parts A & B of medicare are - federal health insurance program referred to as original medicare 
 
Part A? - Hospital insurance 
 
Part B? - Medical ...
What are the external and internal parts of health care compliance? - External: Federal and state statutes and regulations (e.g. HIPPA, FTC) 
Internal: Organizational policies and procedures (e.g. private practice has their own policies and you must follow) 
 
What does the PPACA Section 6401 say...
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Add to cartWhat are the external and internal parts of health care compliance? - External: Federal and state statutes and regulations (e.g. HIPPA, FTC) 
Internal: Organizational policies and procedures (e.g. private practice has their own policies and you must follow) 
 
What does the PPACA Section 6401 say...
Lisa turned 65 and is now eligible for Medicare. She already receives Social Security benefits. How does she enroll in Original Medicare? - Her enrollment in Medicare Parts A and B is generally automatic if she meets all eligibility requirements. 
 
Which statement is true about a member of a Med...
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Add to cartLisa turned 65 and is now eligible for Medicare. She already receives Social Security benefits. How does she enroll in Original Medicare? - Her enrollment in Medicare Parts A and B is generally automatic if she meets all eligibility requirements. 
 
Which statement is true about a member of a Med...
When completing an enrollment application in LEAN, why is an agent prohibited from entering his or her own email address in a field available for the consumer's email address? - The consumer/member would not receive plan related correspondence intended for him/her 
 
By agreeing to the Statement...
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Add to cartWhen completing an enrollment application in LEAN, why is an agent prohibited from entering his or her own email address in a field available for the consumer's email address? - The consumer/member would not receive plan related correspondence intended for him/her 
 
By agreeing to the Statement...
What type of event must agent conduct when she wants to be able to collect consumer information schedule future appointments and accept enrollment applications 
marketing/sales event 
 
 
Louise wants to hold an event that helps consumers understand Medicare programs and perhaps an prove their healt...
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Add to cartWhat type of event must agent conduct when she wants to be able to collect consumer information schedule future appointments and accept enrollment applications 
marketing/sales event 
 
 
Louise wants to hold an event that helps consumers understand Medicare programs and perhaps an prove their healt...
5 most important federal fraud and abuse laws: - *False Claims Act (FCA) 
*Anti - kickback Statute (AKS) 
*Physician Self-Referral Law (Stark I II III ) 
*Exclusion Authorities 
*Civil Monetary Penalties Law (CMPL) 
 
The purpose of EMTALA is to prevent: 
a. Hospitals from rejecting patients in a...
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Add to cart5 most important federal fraud and abuse laws: - *False Claims Act (FCA) 
*Anti - kickback Statute (AKS) 
*Physician Self-Referral Law (Stark I II III ) 
*Exclusion Authorities 
*Civil Monetary Penalties Law (CMPL) 
 
The purpose of EMTALA is to prevent: 
a. Hospitals from rejecting patients in a...
OBB - Operation Bad Bundle- 
Labs, DME, hospice, home health 
 
GAO - General Accounting Office- identified high risk of F/A in Medi 
 
What was the first major auditing target? - Teaching hospital 
 
CPUP - Clinical Practices of the University of Pennsylvania 
 
What was identified by ...
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Add to cartOBB - Operation Bad Bundle- 
Labs, DME, hospice, home health 
 
GAO - General Accounting Office- identified high risk of F/A in Medi 
 
What was the first major auditing target? - Teaching hospital 
 
CPUP - Clinical Practices of the University of Pennsylvania 
 
What was identified by ...
1992. The beginning of intensified provider audits and need for compliance. - GAO identified Medicare claims to be high risk for fraud/waste in what year? 
 
$23 billion - Initial audit determined how much in improper payments? 
 
Teaching Hospitals (University of Pennsylvania) - First Majo...
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Add to cart1992. The beginning of intensified provider audits and need for compliance. - GAO identified Medicare claims to be high risk for fraud/waste in what year? 
 
$23 billion - Initial audit determined how much in improper payments? 
 
Teaching Hospitals (University of Pennsylvania) - First Majo...
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