A grievance request Study guides, Class notes & Summaries

NHA Line of service 130 Questions with 100% Verified Correct Answers 2024/2025 Where changes are made to charges for other items and services that the facility offers, the facility must inform the resident in writing at least - Correct Answer 60 days prior to implementation of the change. The facility must provide the resident with access to personal and medical records pertaining to their self, upon an oral and written request, in the form and format requested by the individual, if it is re...

Brokers/Agents can access the following resources under the Shared Resources section in Centene Workbench. a.Training Resources b.Commission Resources c.Marketing Resources d.All of these d.All of These Although options for capturing and submitting SOAs vary by health plan, Wellcare accepts SOAs in which of the following methods? a.Ascend b.Telephonic c.Paper d.All of these d.All of These Marketing benefits in a service area where those benefits are not available is prohibited and co...

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 from a member or provider for a formal review of an Action (Denial) or Adverse Plan Determination (Medicare) is a/an: Appeal Grievance procedures are separate and distinct from initial determination and appeal procedures. 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. 60

Michigan Builders Exam (2024/2025) Questions with 100%Correct Answers. 5 days - Correct Answer-Time allotted for a residential builder to return sales person's license and for sales person to return I.D. card by certified mail 10 days - Correct Answer-The department, after investigation, may request a licensee to appear at such investigative conference. Notice of a request for a conference shall be in writing and mailed to the address appearing on the license not less than ----- before th...

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: - 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. - 60 An LEP is assessed by CMS when a member goes___days or longer without creditable prescription drug coverage after the...

WellCare ACT Mastery Exam Questions Reviewed And Revised With Correct Answers Guaranteed Pass!! 1) With which types of inquiries can Wellcare's Corporate Sales Support team assist? a. Application and Enrollment b. Onboarding and Certifications c. Commissions d. All of these - ANSWER d. All of these 2) A request to the plan from a member or provider for a formal review of an Action (Denial) or Adverse Plan Determination (Medicare) is a/an: a. Appeal b. Grievan...

Brokers/Agents can access the following resources under the Shared Resources section in Centene Workbench. a.Training Resources b.Commission Resources c.Marketing Resources d.All of these d.All of These Although options for capturing and submitting SOAs vary by health plan, Wellcare accepts SOAs in which of the following methods? a.Ascend b.Telephonic c.Paper d.All of these d.All of These Marketing benefits in a service area where those benefits are not available is prohibite...

WellCare ACT Mastery Exam (Latest 2023/ 2024 Update) Version 2 | Questions and Verified Answers| Grade A| 100% Correct Q: Which elements are available as part of Wellcare's Sales Support model? a. Online b. Local c. Corporate d. All of these Answer: d. All of these Q: 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 these Answer: ...

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-networ...