2023 Centene Cert Review
An agent who has never had any verbal warnings cannot be issued a Corrective Action Plan.
FALSE
Once the enrollment is completed, you can save a copy of the application for your reference.
FALSE
Verbal permission granted to discuss plan details qualifies an authorized representative to complete an application on behalf of the beneficiary.
FALSE
Member PHI can be stored on an external hard drive or a cloud storage service like Google Drive or Apple Cloud.
False
When completing an application, you should ensure that you enter the provider ID of a specialist and not a primary care physician (PCP).
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
Which of the following is not an example of Protected Health Information (PHI)?
Library Card
Which of the following statements about completing telephonic enrollments is FALSE?
Must include most of the required elements necessary to complete the enrollment.
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
____ PDPs will be offered across all 50 U.S. states and Washington, D.C.
Three
All PDPs will continue to offer $0 tier 1 preferred cost-sharing through CVS Medication Home Delivery (Mail Order).
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
For 2023, Ascension Complete added 27 new counties to their footprint.
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.
True
Upon completion of the application, you must provide the beneficiary with the enrollment application confirmation ID.
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
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.
What are some examples of steps that can be taken when safeguarding and securing PHI and PII? (Select all that apply.)
a. Shred documents that contain PHI or PII using appropriate means. b. Never leave laptops, PHI, or PII in an unattended vehicle. c. Do not include PHI or PII in the subject line or body of an email. d. Secure emails that contain PHI or PII.
Communication of PHI can be: (Select all that apply.)
a. Written b. Electronic c. Verbal
Wellcare added ___ counties to their footprint for 2023.
209
Centene's 2023 product expansion represents a __% increase from 2022.
3
Value Script and Value Plus PDP products have a ___-tier formulary structure for 2023.
6
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
Key areas you as an agent have control over and impact upon regarding Star Ratings for quality are:
All of the above
The information contained within ACT will equip agents to certify, market, and sell which health plans?
All of the above
Wellcare offers a range of Medicare plans to provide members with affordable access to:
All of the above
There are ___ LIS copay categories that could be assigned to a member, depending on the level of need.
four
