Wellcare Mastery Exam Questions with 100% Correct Answers | Verified | Updated 2024, Exams of Advanced Education

Download Wellcare Mastery Exam Questions with 100% Correct Answers | Verified | Updated 2024 and more Exams Advanced Education in PDF only on Docsity! Wellcare Mastery Exam Questions with 100% Correct Answers | Verified | Updated 2024 Brokers/Agents can access the following resources under the Shared Resources section in Centene Workbench. a.Training Resources b.Commission Resources c.Marketing Resources d.All of these d.All of These 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 these d.All of These Marketing benefits in a service area where those benefits are not available is prohibited and considered misleading unless that is unavoidable because of local/regional or media use. True False True Which elements are available as part of Wellcare's Sales Support model? a.Online b.Local c.Corporate d.All of these d. All of these 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 c. 60 Brokers/Agents may be investigated after being suspected of noncompliant activity reported through a: (Select all that apply.) a.Complaint Tracking Module (CTM) b.Yelp Review c.Grievance d.Secret Shop Finding a.Complaint Tracking Module (CTM) c.Grievance d.Secret Shop Finding Brokers/Agents can submit a support ticket online through their Centene Workbench portal. True False True When an enrollment application is completed in Ascend, brokers/agents can complete a Health Risk Assessment (HRA) directly in Ascend after the enrollment application, through the Value-Based Enrollment (VBE) portal. True False True Which of the following is not an example of Protected Health Information (PHI)? a.Medical records b.Payment history c.Library card c. Library card A Health Risk Assessment (HRA): a.Provides physicians with an overview of a member's health status. b.Helps us understand the unique health situation of each of our members and allows us to make sure they receive the services that meet their needs. c.Is an important part of our quality initiative, directly impacting our Star Ratings. d.All of these d. All of these The online Centene Workbench self-service portal enables you to: a.Upload applications b.Use the self-service workflows and ticketing system c.Locate valuable documents and resources d.All of these b.Five c.Ten d.Fifteen a. Zero All Prescription Drug Plans (PDPs) will continue to offer $0 Tier 1 preferred cost-sharing through Express Scripts Pharmacy (Mail Order). True False True Which LIS category is assigned to members whose costs are fully subsidized and who receive the most assistance? a.One b.Two c.Three d.Four c. Three Which Prescription Drug Plan (PDP) product features no deductible on any tier? a.Classic b.Value Script c.Value Plus C. Value Plus Which is the Prescription Drug Plan (PDP) Preferred Mail Order network for 2024? a. Express Scripts Pharmacy b.CVS Caremark c.Both A and B a. Express Scripts Pharmacy 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. a.Classic b.Value Plus c.Value Script b.Value Plus A Low-Income Subsidy (LIS) member will be assigned one of ____ copay categories depending on the level of need. a.Two b.Three c.Four d.Five c.Four Wellcare's 2024 product expansion represents a __% increase from 2023. a.One b.Two c.Three d.Five a.One With the Pharmacy Benefit Manager (PBM) migration to Express Scripts effective 1/1/2024, existing members can continue to use their current ID card 1/1/2024 and beyond. True False False The Pharmacy Benefit Manager (PBM) migration to Express Scripts effective 1/1/2024 will impact which plan(s)? a.PDP Only b.MAPD Only c.Both PDP & MAPD c.Both PDP & MAPD An LEP is assessed by CMS when a member goes ______ days or longer without creditable prescription drug coverage after they become Medicare-eligible. a.60 days b.63 days c.65 days d.73 days b.63 days 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. d.Secure emails that contain PHI or PII. CustomPoint sales material order dates will be posted on Wellcare.com. True False False Prior to the beginning of the enrollment process, a broker/agent is required to cover certain beneficiary specific information, including but not limited to: a.Check to see if the beneficiary's PCP and Specialists are in network, explaining they will need to choose new ones or pay out of pocket if not. b.Check the beneficiary's prescriptions are on the formulary and their pharmacy is in network, explaining they will need to choose a new pharmacy or may have to pay the full price of their prescriptions if not. c.Check for other health care needs like Durable Medical Equipment and Physical Therapy. d.All of these d.All of these Ascend is a fast, easy, and compliant way for brokers/agents to submit agent-assisted electronic enrollments. True False True Materials that include plan comparisons or cost-sharing do not require CMS submission. True False False If a requested effective date is available for the special election period being selected, ensure you are requesting a date within the correct timeframe for the member based on their eligibility date or change date needed True False True The online Centene Workbench self-service portal enables you to a.Upload applications b.Use the self-service workflows and ticketing system c.Locate valuable documents and resources d.All of these d. All of these 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: True False True When discussing prescription drug coverage, you should: (Select all that apply.) a.Explain how to use the formulary to look up limitations and exclusions (e.g., step therapy, quantity limits). b.Confirm coverage of the beneficiary's current and/or anticipated prescriptions. c.Explain formulary tiers as well as drug copayment amounts. d.For drugs that are not covered by the new plan, explain the Transition Fill program and how to request a coverage exception a.Explain how to use the formulary to look up limitations and exclusions (e.g., step therapy, quantity limits). b.Confirm coverage of the beneficiary's current and/or anticipated prescriptions. c.Explain formulary tiers as well as drug copayment amounts. d.For drugs that are not covered by the new plan, explain the Transition Fill program and how to request a coverage exception Which LIS category is assigned to members whose costs are fully subsidized and who receive the most assistance? a.One b.Two c.Three d.Four c. Three Brokers/Agents MUST complete a Wellcare Contract Recertification case in Centene Workbench (CWB) every two years. True False False 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 these d. All of theses Wellcare does not need to be informed of all marketing/sales events at which plans or materials will be presented or distributed (formal and informal). True False False 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 c. Member payments 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. True False True From October 1 to October 14, certain activities are Non-Permissible Activities. These include: a.Assist with completing an application b.Collect a completed application c.Advise the beneficiary to complete an applciation prior to October 15. d.All of these d. All of these Dual-eligible and LIS beneficiaries that are not at-risk may use a Dual-Eligible SEP once per each of the ______ calendar quarters only. (Select all that apply.) a.First b.Second c.Third d.Fourth a.First b.Second c.Third A broker/agent who has never had any verbal warnings cannot be issued a Corrective Action Plan. True False False The Mastery Exam will lock for a period of 48 hours after each failed attempt. True False False Beneficiary-facing marketing materials for multiple MA organizations or plans must be submitted to the HPMS Marketing Module by the third-party marketing organization (TPMO) no later than 30 days of use. True False False 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 False True Noting the correct enrollment period on enrollment applications helps in preventing delayed enrollment processing. True False True Once the enrollment is completed, you can save a copy of the application for your reference. True False False With which types of inquiries can Wellcare's Corporate Sales Support team assist? a.Application and Enrollment b.Onboarding and Certifications c.Commissions d.All of thes d. All of these 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.