UHC ethics and compliance section for
certification (Latest Updates)
Questions & Answers 100% Correct {Grade
A}
what must the authorized representative or POA sign on the application - correct
answer they must sign an attestation on the application attesting that they have
necessary legal authority to act on the consumers behalf
NOTE: documention of this authority MUST be available upon request by the plan or
CMS, but you CANNOT require it for the purposes of enrollment
someone who provides assistance to the consumer, but is not authorized to act on the
consumers behalf cannot what? - correct answer sign the enrollment application
Do agents need to collect POA or authorized representation documentation? - correct
answer no they dont
,Will who request the documentation directly from the authorized representative if
needed - correct answer medicare
Should you ever sign the consumers name? - correct answer no
should agents ever send LEAN remote signature emails to themselves in order to
facilitate consumer digital enrollment application signatures? - correct answer no they
shouldn't
Who must provide their own email address and complete their own digital signatures?
- correct answer consumers
Never put your name on the enrollment application as the agent of record if you dont
what - correct answer present the plan to the customer
why? ( consumers become confused when they see an agent named tied to their
enrollment that they do not recognize)
,What is provided in the enrollment application? - correct answer provides notice
acknowledging receipt of the completed enrollment request.
for electronic enrollments, the consumer should be provided what? - correct answer a
confirmation number or tracking number as evidence of the enrollment request was
received.
how many hours is the maximum allotted time for an agent to submit an enrollment
application receipt? - correct answer 24 hours
if the consumer sees a provider and their enrollment request is not approved by CMS,
the consumer will be what - correct answer responsible for all costs
What is a grievance? - correct answer a type of complain consumers and members
may make about the health plan, a health plan agent, one of its network providers and
pharmacies, or quality of care.
This type of complaint does NOT incolve coverage or payment disputes
, When a member enrolls in a MA plan or PDP during AEP or a qualifying SEP, they will
be ______ dis-enrolled from their current MA or PDP plan, even if its offered by a
different provider. - correct answer automatically
When is the effective date of termination for AEP or SEP? - correct answer last day of
the month prior to the effective date of the new enrollment.
The action members may take if they disagree with a coverage plan or payment
decision made by their medicare plan - correct answer appeal
Offers a detailed summary of the plan's benefits, explanation of cost sharing, and lists
special features - correct answer summary of benefits
This happens when the member loses entitlement to medicare Part A or Part B -
correct answer REquireed involentary disenrollment
certification (Latest Updates)
Questions & Answers 100% Correct {Grade
A}
what must the authorized representative or POA sign on the application - correct
answer they must sign an attestation on the application attesting that they have
necessary legal authority to act on the consumers behalf
NOTE: documention of this authority MUST be available upon request by the plan or
CMS, but you CANNOT require it for the purposes of enrollment
someone who provides assistance to the consumer, but is not authorized to act on the
consumers behalf cannot what? - correct answer sign the enrollment application
Do agents need to collect POA or authorized representation documentation? - correct
answer no they dont
,Will who request the documentation directly from the authorized representative if
needed - correct answer medicare
Should you ever sign the consumers name? - correct answer no
should agents ever send LEAN remote signature emails to themselves in order to
facilitate consumer digital enrollment application signatures? - correct answer no they
shouldn't
Who must provide their own email address and complete their own digital signatures?
- correct answer consumers
Never put your name on the enrollment application as the agent of record if you dont
what - correct answer present the plan to the customer
why? ( consumers become confused when they see an agent named tied to their
enrollment that they do not recognize)
,What is provided in the enrollment application? - correct answer provides notice
acknowledging receipt of the completed enrollment request.
for electronic enrollments, the consumer should be provided what? - correct answer a
confirmation number or tracking number as evidence of the enrollment request was
received.
how many hours is the maximum allotted time for an agent to submit an enrollment
application receipt? - correct answer 24 hours
if the consumer sees a provider and their enrollment request is not approved by CMS,
the consumer will be what - correct answer responsible for all costs
What is a grievance? - correct answer a type of complain consumers and members
may make about the health plan, a health plan agent, one of its network providers and
pharmacies, or quality of care.
This type of complaint does NOT incolve coverage or payment disputes
, When a member enrolls in a MA plan or PDP during AEP or a qualifying SEP, they will
be ______ dis-enrolled from their current MA or PDP plan, even if its offered by a
different provider. - correct answer automatically
When is the effective date of termination for AEP or SEP? - correct answer last day of
the month prior to the effective date of the new enrollment.
The action members may take if they disagree with a coverage plan or payment
decision made by their medicare plan - correct answer appeal
Offers a detailed summary of the plan's benefits, explanation of cost sharing, and lists
special features - correct answer summary of benefits
This happens when the member loses entitlement to medicare Part A or Part B -
correct answer REquireed involentary disenrollment
