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 a...
2023 wellcare act mastery certification exam questions with correct answers
by selecting the correct provider during the enrollment process
or any evidence concerning a g
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2023 Wellcare ACT Mastery Certification
2023 Wellcare ACT Mastery Certification
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Par: ateamsuper8 • 2 année de cela
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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 2023 Wellcare ACT Mastery Certification
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
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
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