WellCare Re-Cert Exam 2023 Study Guide Graded A+

WellCare Re-Cert Exam 2023 Study Guide Graded A+ 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 Which of the following is not an example of Protected Health Information (PHI)? Library card Any request or distribution of PHI should contain only the minimum amount of PHI required to complete the intended task. True Which of the following actions are you required to do when contacted regarding an allegation of noncompliant activity? All of the above From October 1st to October 14th, which activity is not permissible by brokers/agents? Assist with completing and collecting completed applications. Brokers/Agents can submit a support ticket online through their Centene Workbench portal. True Health plan fax numbers vary for health plans that offer fax enrollment submissions. True Enrollments through Ascend offer the following unique benefits: (Select all that apply.) a. Validation of important data to help prevent incorrect or missing information. b. Search for providers and formularies to validate physician and prescription availability. c. Extra help eligibility status. d. Digital capture of the broker's/agent's and beneficiary's electronic signatures through Send for Signature at any time throughout the enrollment application. Select all 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 & C 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. 60 The NEW online Centene Workbench self-service portal enables you to: All of the above Which of the following is not considered a grievance? A dispute of the appeal of an organization determination, coverage determination or a Late Enrollment Penalty (LEP) determination. Wellcare offers a range of Medicare plans to provide members with affordable access to: All of the above Clear my choice A Health Risk Assessment (HRA): All of the above Key areas you as a broker/agent have control over and impact upon regarding Star Ratings for quality are: All of the above 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. False 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. True 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). True Wellcare added ___ counties to their footprint for 2023. Classic 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. True Wellcare added ___ counties to their footprint for 2023. 209 All PDPs will feature a $0 tier 1 benefit when filled at preferred pharmacies. True The Wellcare preferred pharmacy network includes Walgreens, CVS, and many grocery chains in 2023. TRUE ____ PDPs will be offered across all 50 U.S. states and Washington, D.C. 3 Value Script and Value Plus PDP products have a ___-tier formulary structure for 2023. 6 The _________ plan is expected to have one of the lowest premiums in the country! Value Script 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 For PDP Medication Home Delivery, the ____ plan will continue to offer a discount for 90-day tier 2, tier 3 and tier 6 prescriptions. Value Plus