In the cms star - Study guides, Class notes & Summaries

2023 United HealthCare - Ethics and Compliance 1. In terms of events, which of the following is true? 2. 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 email address? 3. Annual Election Period (AEP) is a time when 4. You have scheduled an appointment and obtained a Scope of Appointment (SOA) form to discuss Medicare Advantage Plans with a consumer. When you arrive at the app...

Mr. Carlini has heard that Medicare prescription drug plans are only offered through private companies under a program known as Medicare Advantage (MA), not by the government. He likes Original Medicare and does not want to sign up for an MA product, but he also wants prescription drug coverage. What should you tell him? - Mr. Carlini can stay with Original Medicare and also enroll in a Medicare prescription drug plan through a private company that has contracted with the government to provi...

Cynthia is turning 65 on July 5. Her Medicare Part A and Part B will be effective on July 1. Using her Initial Election Period (IEP), when can she submit an application for a Medicare Advantage or Prescription Drug plan? March 1 through July 31 April 1 through October 31 July 1 through December 30 June 1 through July 31 Correct Answer Not July 1 - Dec 30 - WRONG April 1 through October 31 - CORRECT Annual Election Period (AEP) is a time when. . . Consumers can only disenroll from thei...

This year you have decided to focus your efforts on marketing to employer group plans. One employer provides you with a list of their retirees and asks you to contact them to explain the characteristics of the plan they have selected. What should you do? - You may go ahead and call them. Winthrop Brokerage wishes to place an advertisement in the local newspaper that says: "We offer Medicare Advantage plans offered by AB Health and Top Choice Health. Contact us if you would like to learn m...

Cynthia is turning 65 on July 5. Her Medicare Part A and Part B will be effective on July 1. Using her Initial Election Period (IEP), when can she submit an application for a Medicare Advantage or Prescription Drug plan? March 1 through July 31 April 1 through October 31 July 1 through December 30 June 1 through July 31 correct answers Not July 1 - Dec 30 - WRONG April 1 through October 31 - CORRECT Annual Election Period (AEP) is a time when. . . Consumers can only disenroll from the...

In which situation may the Medicare Advantage (MA) organization decide to disenroll a member from an MA plan? -Answer The member calls CMS at 1-800-MEDICARE (Wrong) On October 20, Aries decides to switch his PDP to a Medicare Advantage plan. Aries would like this change to be effective November 1. Which statement is true for Aries? -Answer He may be able to use a Special Election Period to change plans if he qualifies for one. Janine, currently enrolled in a 3-star plan, discovers there is ...

UHC Certification 2024 Exam Questions and Answers 100% Pass Cynthia is turning 65 on July 5. Her Medicare Part A and Part B will be effective on July 1. Using her Initial Election Period (IEP), when can she submit an application for a Medicare Advantage or Prescription Drug plan? March 1 through July 31 April 1 through October 31 July 1 through December 30 June 1 through July 31 - Answer- Not July 1 - Dec 30 - WRONG April 1 through October 31 - CORRECT Annual Election Period (AEP) is a...

In which situation may the Medicare Advantage (MA) organization decide to disenroll a member from an MA plan? : The member calls CMS at 1-800-MEDICARE (Wrong) On October 20, Aries decides to switch his PDP to a Medicare Advantage plan. Aries would like this change to be effective November 1. Which statement is true for Aries? : He may be able to use a Special Election Period to change plans if he qualifies for one. Janine, currently enrolled in a 3-star plan, discovers there is 5-star ...

During an appointment, you may not discuss any products not agreed to in advance by the beneficiary. a. True b. False - True When a paper SOA form is used, it must be completed __________ hosting the sales presentation. a. Prior to b. During c. After - A. Prior to Brokers/Agents can submit a support ticket online through their Centene Workbench portal. Select one: True False - True Wellcare does not need to be informed of all marketing/sales events at which plans or materials wi...

A request to the plan to the plan from a member or provider for a formal review of an Action (Denial) or Adverse Plan Determination (medicare) is a/an: - Answer-a.APPEAL 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 An LEP is assessed by CMS when a member goes___days or longer without creditable prescription drug cove...