Pdps - Study guides, Class notes & Summaries

WELLCARE MASTERY EXAM WITH VERIFIED ANSWERS 1. All three prescription drug plans (PDPs) will offer a five-tier formulary design 2. All Prescription Drug Plans (PDPs) will feature a $0 Tier 1 benefit when filled at preferred pharmacies 3. For 2025, Wellcare preferred networks include Wal- greens, CVS, and some grocery chains False True Tru

The Wellcare preferred pharmacy network includes Walgreens, CVS, and some grocery chains in 2024. - Answer True Wellcare continues to expand its reach by offering more products in a wider geography. ____ new Wellcare plans are going to market. - Answer Twenty-three All Prescription Drug Plans (PDPs) will off er a $___ copay for most Part D preventive vaccines, regardless of which network pharmacy is used by members. - Answer Zero

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...

WELLCARE ACT MASTERY EXAM ACTUAL QUESTIONS AND ANSWERS All Prescription Drug Plans (PDPs) will feature a $0 Tier 1 benefit when filled at preferred pharmacies. - ANSWER-True ____ Prescription Drug Plans (PDPs) will be offered across all 50 U.S. states and Washington, D.C. - ANSWER-Three Noting the correct enrollment period on enrollment applications helps in preventing delayed enrollment processing. - ANSWER-True When verifying a D-SNP beneficiary's Medicaid eligibility through 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...

WellCare ACT Mastery Exam (Latest 2023/ 2024 Update) Version 1 | Questions and Verified Answers| Grade A| 100% Correct Q: Any request or distribution of PHI should contain only the minimum amount of PHI required to complete the intended task. Answer: True Q: Member PHI can be stored on an external hard drive or a cloud storage service like Google Drive or Apple Cloud. Answer: False Q: When completing an enrollment, be sure to use the correct enrollment application fo...

WellCare ACT Mastery Exam (Latest 2023/ 2024 Update) Version 3 | Questions and Verified Answers| Grade A| 100% Correct Q: When explaining the provider network for D-SNPs and C-SNPs: Answer: Avoid submitting applications with no primary care provider (PCP) to assist these higher-risk members. If a member is not connected to a primary care provider (PCP), we should always encourage and assist with connecting them with an in-network doctor Q: If a requested effective date is avai...

With the Pharmacy Benefit Manager (PBM) migration to Express Scripts effective 1/1/2024, existing members can continue to use their current ID card 1/1/2024 and beyond. - Answer-False - With the PBM migration to Express Scripts effective 1/1/2024, all existing members will receive a new ID card containing new pharmacy processing information and must use their new ID card starting 1/1/2024. Wellcare's _____ plan is designed for Low-Income Subsidy members. Question 29Select one:a. Classic b...

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 t...