Wellcare ACT Celene Mastery
The information contained within ACT will equip agents to certify, market, and sell which health plans?
All of the above (Ascension Complete and Wellcare)
Wellcare offers a range of Medicare plans to provide members with affordable access to:
All of the above (Doctors, Hospitals, & Specialists)
Which standalone Prescription Drug Plan is best for a dual-eligible chooser?
Classic
Agents may be investigated after being suspected of noncompliant activity reported through a: (Select all that apply.)
Complaint Tracking Module (CTM),Grievance, and Secret Shop Finding
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.
False
Centene continues to expand its reach by offering more products in a wider geography. ____ new Wellcare and Ascension Complete plans are going to market.
Forty-eight
There are ___ LIS copay categories that could be assigned to a member, depending on the level of need.
Four
Which of the following is not an example of Protected Health Information (PHI)?
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?
Member Payments - (The Six Drivers are Member Service, Serving Government Customers, Selection and Enrollment, Reputation, Requirement of Participation, Bonus Payment.)
Which of the following statements about completing telephonic enrollments is FALSE?
Must include most of the required elements necessary to complete the enrollment.
____ PDPs will be offered across all 50 U.S. states and Washington, D.C.
Three
Agents must meet all required contracting, training, and certification requirements to be eligible to sell Wellcare's Medicare products.
True
All PDPs will continue to offer $0 tier 1 preferred cost-sharing through CVS Medication Home Delivery (Mail Order).
True
All PDPs will feature a $0 tier 1 benefit when filled at preferred pharmacies.
True
Any request or distribution of PHI should contain only the minimum amount of PHI required to complete the intended task.
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.
True
Centene requires all contracted agents to read, understand, and agree to Centene's Business Ethics and Code of Conduct Policy.
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.
True
For 2023, Ascension Complete added 27 new counties to their footprint.
True
Noting the correct enrollment period on enrollment applications helps in preventing delayed enrollment processing.
True
To ensure accurate data entry, you should repeat the Medicare ID back to the beneficiary. Select One
True
Upon completion of the application, you must provide the beneficiary with the enrollment application confirmation ID.
True
When enrolling a D-SNP beneficiary, be sure to verify plan enrollment eligibility and that the Medicare Savings Program (MSP) level is eligible for the requested plan.
True
For PDP Medication Home Delivery, the ____ plan will continue to offer a discount for 90-day tier 2, tier 3 and tier 6 prescriptions.
Value Plus
The _________ plan is expected to have one of the lowest premiums in the country!
Value Script
You can help prevent grievances by: (Select all that apply.)
a. Always confirming availability of the beneficiary's primary and specialist providers by using the provider search tool available on the plan's website. b. Always using plan materials to clearly explain plan benefits and cost (including medications) and check for understanding. c. Always confirming a beneficiary's intent to enroll before accepting their enrollment application. (All of the above)
Wellcare added ___ counties to their footprint for 2023.
209
Centene's 2023 product expansion represents a __% increase from 2022.
3
Which of the following is not considered a grievance?
A dispute of the appeal of an organization determination, coverage determination or a Late Enrollment Penalty (LEP) determination.