By selecting the correct provider during the enrollment process, you can: - ANSWER All of the above
A grievance request, or any evidence concerning a grievance, must be fi led orally or in writing no later than _____ calendar days from the date of the event or the date the member is made aware o...
by selecting the correct provider during the enrollment process
you can
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2023 Wellcare ACT
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2023 Wellcare ACT Mastery Certification
By selecting the correct provider during the enrollment process, you can: - ANSWER All
of the above
A grievance request, or any evidence concerning a grievance, must be fi led 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
The Single Sign-On Portal provides access to several applications, including Centene
Workbench. - 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. - ANSWER True
Brokers/Agents may be investigated after being suspected of noncompliant activity
reported through a: - ANSWER -Complaint Tracking Module (CTM)
-Grievance
-Secret Shop Finding
The NEW online Centene Workbench self-service portal enables you to: - ANSWER All
of the above
When discussing prescription drug coverage, you should: - ANSWER -Explain how to
use the formulary to look up limitations and exclusions (e.g., step therapy, quantity
limits).
-Confirm coverage of the beneficiary's current and/or anticipated prescriptions.
-Explain formulary tiers as well as drug copayment amounts.
-For drugs that are not covered by the new plan, explain the Transition Fill program and
how to request a coverage exception.
Once the enrollment is completed, you can save a copy of the application for your
reference. - ANSWER False
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. - ANSWER False
Which resources are available for download from the Shared Resources section found
within Centene Workbench? - ANSWER All of the above
During an appointment, you may not discuss any products not agreed to in advance by
the beneficiary. - 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. - ANSWER True
, 2023 Wellcare ACT Mastery Certification
A broker/agent who has never had any verbal warnings cannot be issued a Corrective
Action Plan. - ANSWER False
Member PHI can be stored on an external hard drive or a cloud storage service like
Google Drive or Apple Cloud. - ANSWER False
When a paper SOA form is used, it must be completed __________ hosting the sales
presentation. - ANSWER Prior to
Prior to completing the enrollment form, you should always confirm the beneficiary's
primary care physician (PCP) and/or specialists. - ANSWER True
Which of the following statements about Scope of Appointment (SOA) is FALSE? -
ANSWER An electronic SOA submitted in Ascend must be in a Pending status prior to
beginning the appointment.
The beneficiary (or their authorized representative) must indicate the product types to
be discussed during the appointment on the Scope of Appointment (SOA). - ANSWER
True
Centene's 2023 product expansion represents a __% increase from 2022. - ANSWER 3
For 2023, Ascension Complete added 27 new counties to their footprint. - ANSWER
True
For PDP Medication Home Delivery, the ____ plan will continue to offer a discount for
90-day tier 2, tier 3 and tier 6 prescriptions. - ANSWER Value Plus
Wellcare added ___ counties to their footprint for 2023. - ANSWER 209
The Part D Senior Savings Model (SSM), which reduces member spending on insulin,
will be offered on all Value Script, Value Plus PDPs, and select Wellcare MAPD plans. -
ANSWER True
____ PDPs will be offered across all 50 U.S. states and Washington, D.C. - ANSWER
Three
Which standalone Prescription Drug Plan is best for a dual-eligible chooser? - ANSWER
Classic
All PDPs will feature a $0 tier 1 benefit when filled at preferred pharmacies. - ANSWER
True
All PDPs will continue to offer $0 tier 1 preferred cost-sharing through CVS Medication
Home Delivery (Mail Order). - ANSWER True
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