Wellcare 2023
You can help prevent grievances by:
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.
Which of the following statements about Scope of Appointment (SOA) is FALSE?
An electronic SOA submitted in Ascend must be in a Pending status prior to beginning the appointment.
Which option is the preferred method to submit enrollment?
Ascend Web/Mobile Application
From October 1st to October 14th, which activity is not permissible by brokers/agents?
Assist with completing and collecting completed applications.
Brokers/Agents may be investigated after being suspected of noncompliant activity reported through a:
Complaint Tracking Module (CTM) Grievance Secret Shop Finding
Once the enrollment is completed, you can save a copy of the application for your reference.
F
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
When a paper SOA form is used, it must be completed __________ hosting the sales presentation.
Prior to
All PDPs will continue to offer $0 tier 1 preferred cost-sharing through CVS Medication Home Delivery (Mail Order).
T
Ascend is a fast, easy, and compliant way for brokers/agents to submit agent-assisted electronic enrollments.
T
The Wellcare preferred pharmacy network includes Walgreens, CVS, and many grocery chains in 2023.
T
Which standalone Prescription Drug Plan is best for a dual-eligible chooser?
The Classic standalone Prescription Drug Plan is best for a dual-eligible chooser
Centene requires all contracted brokers/agents to read, understand, and agree to Centene's Business Ethics and Code of Conduct Policy.
True
During an appointment, you may not discuss any products not agreed to in advance by the beneficiary.
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
Prior to completing the enrollment form, you should always confirm the beneficiary's primary care physician (PCP) and/or specialists.
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
Enrollments through Ascend offer the following unique benefits:
Validation of important data to help prevent incorrect or missing information. Digital capture of the broker's/agent's and beneficiary's electronic signatures through Send for Signature at any time throughout the enrollment application.
For PDP Medication Home Delivery, the ____ plan will continue to offer a discount for 90-day tier 2, tier 3 and tier 6 prescription
Value Plus
The _________ plan is expected to have one of the lowest premiums in the country!
Value Script
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.
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.
Wellcare added ___ counties to their footprint for 2023.
209
Centene's 2023 product expansion represents a __% increase from 2022.
3
____ PDPs will be offered across all 50 U.S. states and Washington, D.C
3
There are ___ LIS copay categories that could be assigned to a member, depending on the level of need.
4
Centene continues to expand its reach by offering more products in a wider geography. ____ new Wellcare and Ascension Complete plans are going to market.
48
Health Risk Assessment
All of the above
