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2023/2024 Wellcare - Mastery Test
____ PDPs will be offered across all 50 U.S. states and Washington, D.C. a. Two b. Three c. Four d. Five - ANSWER-B. Three ______ events are designed to inform the people that attend about Medicare Advantage, Prescription Drug, or other Medicare programs without going into the specifics of a particular carrier. - ANSWER-Educational A broker/agent may be terminated for cause if they fail to comply with a compliance investigation, encourage others to avoid the compliance interview process, or fail to provide truthful or complete information. Select one: True False - ANSWER-True A broker/agent who has never had any verbal warnings cannot be issued a Corrective Action Plan. Select one: True False - ANSWER-False 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. a. 30 b. 45 c. 60 d. 90 - ANSWER-C. 60 A Health Risk Assessment (HRA) can be completed for C-SNP and D-SNP plans only, before the enrollment application process in Ascend through the Value Based Enrollment (VBE) portal. Select one: True False - ANSWER-False
A Health Risk Assessment (HRA): - ANSWER-All of the above All PDPs will continue to offer $0 tier 1 preferred cost-sharing through CVS Medication Home Delivery (Mail Order). Select one: True False - ANSWER-True All PDPs will feature a $0 tier 1 benefit when filled at preferred pharmacies. Select one: True False - ANSWER-True Although options for capturing and submitting SOAs vary by health plan, Wellcare accepts SOAs in which of the following methods? a. Ascend b. Telephonic c. Paper d. All of the above - ANSWER-D. All of the above Any request or distribution of PHI should contain only the minimum amount of PHI required to complete the intended task. Select one: True False - ANSWER-True Ascend is a fast, easy, and compliant way for brokers/agents to submit agent-assisted electronic enrollments. Select one: True False - ANSWER-True Beneficiary-facing content that includes generic or plan-specific product or benefit information must be submitted for review and CMS submission, as well as acceptance or approval, prior to distribution. Select one: True False - ANSWER-True
Communication of PHI can be: (Select all that apply.) a. Written b. Electronic c. Verbal - ANSWER-All Apply During an appointment, you may not discuss any products not agreed to in advance by the beneficiary. a. True b. False - ANSWER-True Enrollment applications must be received by Wellcare no later than ___ calendar day(s) following receipt from the beneficiary. a. 1 b. 3 c. 5 d. 7 - ANSWER-A. 1 Enrollments through Ascend offer the following unique benefits: (Select all that apply.) - ANSWER-ALL APPLY 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. Select one: True False - ANSWER-True For 2023, Ascension Complete added 27 new counties to their footprint. Select one: True False - ANSWER-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. a. Classic b. Value Plus c. Value Script - ANSWER-B. Value plus From October 1st to October 14th, which activity is not permissible by brokers/agents?
a. Host events/1:1 appointments and discuss 2023 plan benefits. b. Use CMS-approved 2023 sales material. c. Assist with completing and collecting completed applications. d. Leave an application and BRE with only your broker/agent information populated with the beneficiary. - ANSWER-c. Assist with completing and collecting completed applications. Health plan fax numbers vary for health plans that offer fax enrollment submissions. Select one: True False - ANSWER-True Key areas you as a broker/agent have control over and impact upon regarding Star Ratings for quality are: a. Member Satisfaction/Experience b. Complaints c. Rapid Disenrollment d. All of the above - ANSWER-D. All of the above Low-Income Subsidy (LIS)/Medicaid Lookup status verification in Ascend is: (Select all that apply.) a. Available for LIS level searches in all states. b. Available for Medicaid status searches in select states. c. A way to assist brokers/agents with enrolling beneficiaries into the right plan based on their extra help status. - ANSWER-ALL APPLY 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? a. Member Service b. Reputation c. Member Payments d. Serving Government Customers - ANSWER-C. Member Payments Member PHI can be stored on an external hard drive or a cloud storage service like Google Drive or Apple Cloud. - ANSWER-False Noting the correct enrollment period on enrollment applications helps in preventing delayed enrollment processing. Select one: True
The Wellcare preferred pharmacy network includes Walgreens, CVS, and many grocery chains in 2023. Select one: True False - ANSWER-True There are ___ LIS copay categories that could be assigned to a member, depending on the level of need. a. two b. three c. four d. five - ANSWER-C. Four Value Script and Value Plus PDP products have a ___-tier formulary structure for 2023. a. 3 b. 4 c. 5 d. 6 - ANSWER-D. 6 Wellcare added ___ counties to their footprint for 2023. a. 122 b. 209 c. 284 d. 327 - ANSWER-B. 209 Wellcare does not need to be informed of all marketing/sales events at which plans or materials will be presented or distributed (Formal & Informal). Select one: True False - ANSWER-False Wellcare must receive notice of an event change or cancellation as soon as possible, but no later than 30 minutes after the event start time. Select one: True False - ANSWER-False Wellcare offers a range of Medicare plans to provide members with affordable access to:
a. Doctors b. Hospitals c. Specialists d. All of the above - ANSWER-D. All of the Above What are some examples of steps that can be taken when safeguarding and securing PHI and PII? (Select all that apply.) - ANSWER-ALL 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. - ANSWER-All (A,B,C,D) What type of inquiries can Wellcare's Corporate Sales Support team assist with? a. Application and Enrollment b. Onboarding and Certifications c. Commissions d. All of the above - ANSWER-D. All of the above When a paper SOA form is used, it must be completed __________ hosting the sales presentation. a. Prior to b. During c. After - ANSWER-A. Prior to When discussing prescription drug coverage, you should: (Select all that apply.) - ANSWER-All apply Which elements are available as part of Wellcare's sales support model? - ANSWER-All of the above Which of the following actions are you required to do when contacted regarding an allegation of noncompliant activity? a. Speak with the investigator as quickly as possible. b. Answer all questions honestly and completely. c. Offer information and documents important to the investigation. d. All of the above - ANSWER-D. All of the above Which of the following is not an example of Protected Health Information (PHI)?
