ACTUAL Exam Questions and CORRECT
Answers
When enrolling a D-SNP beneficiary, be sure to verify plan enrollment eligibility and that the
Medicare Savings Program (MSP) level is eligible for the requested plan. - 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
Which of the following is not considered a grievance? - CORRECT ANSWER - A dispute
of the appeal of an organization determination, coverage determination or a Late Enrollment
Penalty (LEP) determination
To ensure accurate data entry, you should repeat the Medicare ID back to the beneficiary -
CORRECT ANSWER - True
Which of the following is not an example of Protected Health Information (PHI)? - CORRECT
ANSWER - Library Card
When completing an application, you should ensure that you enter the provider ID of a specialist
and not a primary care physician (PCP). - CORRECT ANSWER - False
An agent who has never had any verbal warnings cannot be issued a Corrective Action Plan. -
CORRECT ANSWER - 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? - CORRECT ANSWER - Member of Service
, Once the enrollment is completed, you can save a copy of the application for your reference. -
CORRECT ANSWER - False
Verbal permission granted to discuss plan details qualifies an authorized representative to
complete an application on behalf of the beneficiary. - CORRECT ANSWER - False
Agents must meet all required contracting, training, and certification requirements to be eligible
to sell Wellcare's Medicare products. - CORRECT ANSWER - True
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. - CORRECT ANSWER - True
Key areas you as an agent have control over and impact upon regarding Star Ratings for quality
are: - CORRECT ANSWER - All of the above
Communication of PHI can be:
(Select all that apply.) - CORRECT ANSWER - Select all
Written, Electronic, Verbal
Any request or distribution of PHI should contain only the minimum amount of PHI required to
complete the intended task - CORRECT ANSWER - True
You can help prevent grievances by:
(Select all that apply.) - CORRECT ANSWER - Select All
What are some examples of steps that can be taken when safeguarding and securing PHI and PII?
(Select all that apply.) - CORRECT ANSWER - -Never leave laptops, PHI, or PII in an
unattended vehicle.
-Do not include PHI or PII in the subject line or body of an email.
-Secure emails that contain PHI or PII.