Wellcare ACT Mastery Exam 2023/2024 with Complete Solutions

Wellcare ACT Mastery Exam 2023/2024 with Complete Solutions Centene requires all contracted brokers/agents to read, understand, and agree to Centene's Business Ethics and Code of Conduct Policy. True False True 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 d. All of the above Communication of PHI can be: (Select all that apply.) a. Written b. Electronic c. Verbal a, b, c 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 False 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 Clear my choice a. 1 Ascend is a fast, easy, and compliant way for brokers/agents to submit agent-assisted electronic enrollments. Select one: True False True During an appointment, you may not discuss any products not agreed to in advance by the beneficiary. Select one: True False True A Health Risk Assessment (HRA): a. Provides physicians with an overview of a member's health status. b. Ensures members are able to access care and receive services that meet their needs. c. Is an important part of our quality initiative, directly impacting our Star Ratings. d. All of the above d. All of the above Which elements are available as part of Wellcare's sales support model? a. Online b. Local c. Corporate d. All of the above d. All of the above Once the enrollment is completed, you can save a copy of the application for your reference. Select one: True False False Which of the following statements about Scope of Appointment (SOA) is FALSE? a. A signed and completed Scope of Appointment (SOA) is required to be submitted for all agent-assisted enrollments. b. You may not discuss any products not agreed to in advance by the beneficiary. c. An electronic SOA submitted in Ascend must be in a Pending status prior to beginning the appointment. d. SOAs are required for all personal and individual sales appointments, regardless of the venue or client relationship (e.g., in-home, conference call, library, walk-in to a broker/agent office). c. An electronic SOA submitted in Ascend must be in a Pending status prior to beginning the appointment. 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 When a paper SOA form is used, it must be completed __________ hosting the sales presentation. a. Prior to b. During c. After a. Prior to Which resources are available for download from the Shared Resources section found within Centene Workbench? a. Contacts & Communications b. Marketing Resources c. Benefits Resources d. All of the above d. All of the above 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 True Which of the following is not considered a grievance? a. An agent contacting a beneficiary without consent. b. Premium and copay complaints. c. A dispute of the appeal of an organization determination, coverage determination or a Late Enrollment Penalty (LEP) determination. d. Enrollment or disenrollment concerns. Clear my choice c. A dispute of the appeal of an organization determination, coverage determination or a Late Enrollment Penalty (LEP) determination. 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 Clear my choice c. Member Payments 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 d. All of the above All PDPs will feature a $0 tier 1 benefit when filled at preferred pharmacies. Select one: True False True All PDPs will continue to offer $0 tier 1 preferred cost-sharing through CVS Medication Home Delivery (Mail Order). Select one: True False 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 b.Value Plus The _________ plan is expected to have one of the lowest premiums in the country! a. Classic b. Value Plus c. Value Script c. Value Script Wellcare added ___ counties to their footprint for 2023. a. 122 b. 209 c. 284 d. 327 Clear my choice b. 209 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. Select one: True False 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. Select one: True False True Value Script and Value Plus PDP products have a ___-tier formulary structure for 2023. a. 3 b. 4 c. 5 d. 6 d. 6 For 2023, Ascension Complete added 27 new counties to their footprint. Select one: True False True The Wellcare preferred pharmacy network includes Walgreens, CVS, and many grocery chains in 2023. Select one: True False True Centene continues to expand its reach by offering more products in a wider geography. ____ new Wellcare and Ascension Complete plans are going to market. a. Thirty-three b. Forty-eight c. Fifty-two b. Forty-eight Centene's 2023 product expansion represents a __% increase from 2022. a. 1 b. 2 c. 3 d. 5 c. 3