2023 wellcare - Mastery Test

Wellcare must receive notice of an event change or cancellation as soon as possible, but no later than 30 minutes after the event start time. Select one: True False

False

Beneficiary-facing content that includes generic or plan-specific product or benefit information must be submitted for review and CMS submission, as well as acceptance or approval, prior to distribution. Select one: True False

True

Brokers/Agents must meet all required contracting, training, and certification requirements to be eligible to sell Wellcare's Medicare Products. Select one: True False

True

Centene has new PPO D-SNP product expansion in CT, IN, KS, KY, MS, OH, OK, PA, SC, and a new HMO D-SNP in LA. Select one: True False

True

Enrollment applications must be received by Wellcare no later than ___ calendar day(s) following receipt from the beneficiary. a. 1 b. 3 c. 5 d. 7

A. 1

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

What are some examples of steps that can be taken when safeguarding and securing PHI and PII? (Select all that apply.)

ALL

Enrollments through Ascend offer the following unique benefits: (Select all that apply.)

ALL APPLY

You can help prevent grievances by: (Select all that apply.)

ALL APPLY

Communication of PHI can be: (Select all that apply.) a. Written b. Electronic c. Verbal

All Apply

When discussing prescription drug coverage, you should: (Select all that apply.)

All apply

The NEW online Centene Workbench self-service portal enables you to:

All of the Above

Wellcare added ___ counties to their footprint for 2023. a. 122 b. 209 c. 284 d. 327

B. 209

Centene continues to expand its reach by offering more products in a wider geography. ____ new Wellcare and Ascension Complete plans are going to market. a. Thirty-three b. Forty-eight c. Fifty-two

B. 48

Centene's 2023 product expansion represents a __% increase from 2022. a. 1 b. 2 c. 3 d. 5

C. 3

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. a. 30 b. 45 c. 60 d. 90

C. 60

Value Script and Value Plus PDP products have a ___-tier formulary structure for 2023. a. 3 b. 4 c. 5 d. 6

D. 6

Wellcare offers a range of Medicare plans to provide members with affordable access to: a. Doctors b. Hospitals c. Specialists d. All of the above

D. All of the Above

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 the above

D. All of the above

What type of inquiries can Wellcare's Corporate Sales Support team assist with? a. Application and Enrollment b. Onboarding and Certifications c. Commissions d. All of the above

D. All of the above

______ events are designed to inform the people that attend about Medicare Advantage, Prescription Drug, or other Medicare programs without going into the specifics of a particular carrier.

Educational

A broker/agent who has never had any verbal warnings cannot be issued a Corrective Action Plan. Select one: True False

False

Wellcare does not need to be informed of all marketing/sales events at which plans or materials will be presented or distributed (Formal & Informal). Select one: True False

False

All PDPs will continue to offer $0 tier 1 preferred cost-sharing through CVS Medication Home Delivery (Mail Order). Select one: True False

True

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. Select one: True False

True

The Single Sign-On Portal provides access to several applications, including Centene Workbench. Select one: True False

True

The Wellcare preferred pharmacy network includes Walgreens, CVS, and many grocery chains in 2023. Select one: True False

True

The beneficiary (or their authorized representative) must indicate the product types to be discussed during the appointment on the Scope of Appointment (SOA).

True

From October 1st to October 14th, which activity is not permissible by brokers/agents? a. Host events/1:1 appointments and discuss 2023 plan benefits. b. Use CMS-approved 2023 sales material. c. Assist with completing and collecting completed applications. d. Leave an application and BRE with only your broker/agent information populated with the beneficiary.

c. Assist with completing and collecting completed applications.

____ PDPs will be offered across all 50 U.S. states and Washington, D.C. a. Two b. Three c. Four d. Five

B. Three

For PDP Medication Home Delivery, the ____ plan will continue to offer a discount for 90-day tier 2, tier 3 and tier 6 prescriptions. a. Classic b. Value Plus c. Value Script

B. Value plus

Which of the following is not considered a grievance? a. An agent contacting a beneficiary without consent. b. Premium and copay complaints. c. A dispute of the appeal of an organization determination, coverage determination or a Late Enrollment Penalty (LEP) determination. d. Enrollment or disenrollment concerns.

C. A dispute of the appeal of an organization determination, coverage determination or a Late Enrollment Penalty (LEP) determination.

Which standalone Prescription Drug Plan is best for a dual-eligible chooser? a. Value Script (not correct) b. Value Plus c. Classic

C. Classic

There are ___ LIS copay categories that could be assigned to a member, depending on the level of need. a. two b. three c. four d. five

C. Four

Which of the following is not an example of Protected Health Information (PHI)? a. Medical records b. Payment history c. Library card

C. Library Card

Medicare Star Ratings and performance are at the forefront of Wellcare's quality strategy. Wellcare's quality focus consists of six drivers. Which of the following is not a Wellcare quality driver? a. Member Service b. Reputation c. Member Payments d. Serving Government Customers

C. Member Payments

The _________ plan is expected to have one of the lowest premiums in the country! a. Classic b. Value Plus c. Value Script

C. Value script

Brokers/Agents may be investigated after being suspected of noncompliant activity reported through a: (Select all that apply.)

Complaint Tracking Module (CTM) Grievance Secret Shop Finding

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 the above

D. All of the above

Which of the following actions are you required to do when contacted regarding an allegation of noncompliant activity? a. Speak with the investigator as quickly as possible. b. Answer all questions honestly and completely. c. Offer information and documents important to the investigation. d. All of the above

D. All of the above

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. Select one: True False

False

Member PHI can be stored on an external hard drive or a cloud storage service like Google Drive or Apple Cloud.

False

Once the enrollment is completed, you can save a copy of the application for your reference. Select one: True False

False

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. Select one: True False

True

All PDPs will feature a $0 tier 1 benefit when filled at preferred pharmacies. Select one: True False

True

Any request or distribution of PHI should contain only the minimum amount of PHI required to complete the intended task. Select one: True False

True

Ascend is a fast, easy, and compliant way for brokers/agents to submit agent-assisted electronic enrollments. Select one: True False

True

Brokers/Agents can submit a support ticket online through their Centene Workbench portal. Select one: True False

True

Centene requires all contracted brokers/agents to read, understand, and agree to Centene's Business Ethics and Code of Conduct Policy. Select one: True False

True

During an appointment, you may not discuss any products not agreed to in advance by the beneficiary. a. True b. False

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. Select one: True False

True

For 2023, Ascension Complete added 27 new counties to their footprint. Select one: True False

True

Health plan fax numbers vary for health plans that offer fax enrollment submissions. Select one: True False

True

Noting the correct enrollment period on enrollment applications helps in preventing delayed enrollment processing. Select one: True False

True

Prior to completing the enrollment form, you should always confirm the beneficiary's primary care physician (PCP) and/or specialists. Select one: True False

True

Which of the following statements about Scope of Appointment (SOA) is FALSE? a. A signed and completed Scope of Appointment (SOA) is required to be submitted for all agent-assisted enrollments. b. You may not discuss any products not agreed to in advance by the beneficiary. c. An electronic SOA submitted in Ascend must be in a Pending status prior to beginning the appointment. d. SOAs are required for all personal and individual sales appointments, regardless of the venue or client relationship (e.g., in-home, conference call, library, walk-in to a broker/agent office).

c. An electronic SOA submitted in Ascend must be in a Pending status prior to beginning the appointment.

Low-Income Subsidy (LIS)/Medicaid Lookup status verification in Ascend is: (Select all that apply.) a. Available for LIS level searches in all states. b. Available for Medicaid status searches in select states. c. A way to assist brokers/agents with enrolling beneficiaries into the right plan based on their extra help status.

ALL APPLY

What are some examples of what can trigger a beneficiary complaint? (Select all that apply.) a. Did not consent to enroll in the plan. b. Received incorrect plan benefit information or were dissatisfied with plan benefits. c. Had enrollment/disenrollment issues (e.g., disenrollment/cancellation requests, late enrollment penalty, loss of entitlement). d. Were misled about which providers were in-network.

All (A,B,C,D)

A Health Risk Assessment (HRA):

All of the above

The information contained within ACT will equip brokers/agents to certify, market, and sell which health plans?

All of the above

Which elements are available as part of Wellcare's sales support model?

All of the above

Which resources are available for download from the Shared Resources section found within Centene Workbench?

All of the above