Anthem - Risk Prevention Assessment 2022
What does the Allegations process allow the plan to do?
All of the above statements are correct
In this module, which of the following terms do NOT refer to a single occurrence of marketing misrepresentation?
All of these terms refer to an occurrence of marketing misrepresentation
Provider Networks may be accessed through what methods?
Both A and B may be used
Agents are permitted to call former members who have voluntarily disenrolled or current members in the process of disenrolling to market plans or products.
False
Agents/Brokers are allowed to offer gifts as a condition of enrollment.
False
When a beneficiary is trying to decide between plans during a sales appointment, it is okay to omit information critical to the beneficiary if they don't ask pointed questions.
False
Disciplinary actions are not always required, depending on the outcome of the case.
True
Documents with beneficiary information (such as withdrawn, incomplete, or incorrect applications, or records at the end of the required retention period) must be properly disposed of via cross cut shredding and NOT reused or placed into regular recycling or trash containers.
True
If a beneficiary currently has drug coverage through another carrier, you must verify their prescriptions would be covered under our plan's formulary, too. The drugs that are actually covered may vary from one carrier to another or one plan to another.
True
If a beneficiary wants you to hold an enrollment form/application, you must explain that you can either submit or cancel the enrollment form/application following established procedures.
True
Not all providers are contracted to serve as a primary care physician (PCP). Use the online tool to find/verify the PCP indicator information.
True
You MUST EXPLAIN the Part D late enrollment penalty.
True
You MUST tell your PPO plan clients they will have to pay more when seeking non-emergent eligible services outside of the network.
True
Which of these activities would NOT be classified as marketing misrepresentation?
Using the beneficiary's P.O. Box as a mailing address, but not as a permanent address
You receive a questionnaire regarding a sales misrepresentation inquiry. The questionnaire regarding the complaint must be completed and returned promptly. When must you return your response?
Within 48 hours