Download 2024 Wellcare Mastery Test Exam Verified Questions And Answers With Complete Solutions and more Exams Advanced Education in PDF only on Docsity! 2024 Wellcare Mastery Test Exam Verified Questions And Answers With Complete Solutions An SEP is a period outside of the ICEP, AEP, or MA OEP when beneficiaries can enroll based solely on life events that qualify for an SEP period - Correct Answer-answer: True Any request or distribution of PHI should contain only the minimum amount of PHI required to complete the intended task. - Correct Answer-Answer: TRUE A request to the plan from a member or provider for a formal review of an Action (Denial) or Adverse Plan Determination (Medicare) is a/an: - Correct Answer-Answer: Appeal An agent who has never had any verbal warnings cannot be issued a Corrective Action Plan - Correct Answer-Answer: False Which of the following actions are you required to do when contacted regarding an allegation of noncompliant activity? - Correct Answer-Answer: All of these Which of the following statements about completing telephonic enrollments is FALSE? - Correct Answer-c. 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. - Correct Answer-True At the end of this course, there will be a Mastery Exam. Agents must achieve a passing score of 85% or higher to successfully complete this course. - Correct Answer-True 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? - Correct Answer-c. Member Payments Members who fail to pay the required premiums before the end of the grace period (Wellcare has a three-month grace period) will be terminated. - Correct Answer-True Member PHI can be stored on an external hard drive or a cloud storage service like Google Drive or Apple Cloud. - Correct Answer-False You can help prevent grievances by: - Correct Answer-Answer: A,B and C Low-Income Subsidy (LIS), which is often referred to as Extra Help, reduces all Part D plan premiums. - Correct Answer-false Which of the following is not considered a grievance? - Correct Answer-c. A dispute of the appeal of an organization determination, coverage determination, or a Late Enrollment Penalty (LEP) determination. When completing an enrollment, be sure to use the correct enrollment application for the desired plan year. - Correct Answer-true When explaining the provider network for D-SNPs and C-SNPs: - Correct Answer-a. Avoid submitting applications with no primary care provider (PCP) to assist these higher-risk members. b. If a member is not connected to a primary care provider (PCP), we should always encourage and assist with connecting them with an in-network doctor. The TPMO disclaimer must be used by any TPMO that sells plans on behalf of more than one MA plan provider. The disclaimer must be: - Correct Answer-A,B,C & D Noting the correct enrollment period on enrollment applications helps in preventing delayed enrollment processing. - Correct Answer-true CVS Caremark Mail Order will be in-network for 2024. - Correct Answer-false Which standalone Prescription Drug Plan (PDP) is best for a dual-eligible chooser? - Correct Answer-classic Which is the Prescription Drug Plan (PDP) Preferred Mail Order network for 2024? - Correct Answer-a. Express Scripts Pharmacy ____ Prescription Drug Plans (PDPs) will be offered across all 50 U.S. states and Washington, D.C. - Correct Answer-three For Prescription Drug Plan (PDP) Medication Home Delivery, the ____ plan will continue to offer a discount (2.5 x 30-day preferred retail copay) for Tier 2, 3, and 6 prescriptions - Correct Answer-b. Value Plus The Wellcare preferred pharmacy network includes Walgreens, CVS, and some grocery chains in 2024. - Correct Answer-true Wellcare's _____ plan is designed for Low-Income Subsidy members. - Correct Answer- a.
