Wellcare 2023 questions & answers

Wellcare 2023 questions & answersNoting the correct enrollment period on enrollment applications helps in preventing delayed enrollment processing. Select one: 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 All the above By selecting the correct provider during the enrollment process, you can: a. Increase member satisfaction. b. Ensure timely access to the member's PCP. c. Minimize call volumes/complaints. d. All of the above All the above Centene requires all contracted agents to read, understand, and agree to Centene's Business Ethics and Code of Conduct Policy. Select one: 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 Library card Communication of PHI can be: (Select all that apply.) a. Written b. Electronic c. Verbal Written, Electronic, Verbal 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 Member Payments Verbal permission granted to discuss plan details qualifies an authorized representative to complete an application on behalf of the beneficiary. Select one: True False False 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 Complaint Tracking Module (CTM), Grievance, Secret Shop Finding 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. Select one: True False True The information contained within ACT will equip agents to certify, market, and sell which health plans? a. Ascension Complete b. Wellcare c. All of the above All of the above An agent who has never had any verbal warnings cannot be issued a Corrective Action Plan. Select one: True False False Once the enrollment is completed, you can save a copy of the application for your reference. Select one: True False False What are some examples of what can trigger a beneficiary complaint? (Select all that apply.) a. Did not consent to enroll in the plan. b. Received incorrect plan benefit information or were dissatisfied with plan benefits. c. Had enrollment/disenrollment issues (e.g., disenrollment/cancellation requests, late enrollment penalty, loss of entitlement). d. Were misled about which providers were in-network. Did not consent to enroll in the plan, Received incorrect plan benefit information or were dissatisfied with plan benefits, Were misled about which providers were in-network Member PHI can be stored on an external hard drive or a cloud storage service like Google Drive or Apple Cloud. Select one: True False False When completing an application, you should ensure that you enter the provider ID of a specialist and not a primary care physician (PCP). Select one: True False False