Wellcare Exam 2024
___Events are designed to inform the people who attend about Medicare Advantage,
Prescription Drug,
or other Medicare programs without going into the specifics of a particular carrier. - questions
and answers-EDUCATIONAL
___Prescription drug plans (PDPs) will be offered across all 50 US states and Washington DC -
questions and answers-THREE
A broker/ agent who has never had any verbal warnings cannot be issued a corrective action
plan. - questions and answers-FALSE
A broker/agent may be terminated for cause if they fail to comply with compliance investigation,
encourage others to avoid the compliance interview process, or fail to provide truthful complete
information. - questions and answers-TRUE
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. - questions and answers-60
A Health Risk Assessment (HRA): - questions and answers-a. Provides physiscians with an
overview of a member's health status.
B. help us understand the
unique health situation og each of our members and allows us to make sure they receive the
services that meet their needs.
c. is an important part of our quality initiative, directly
impacting our star ratings.
D. ALL OF THESE (CORRECT)
A Low-income subsidy (LIS) member will be assigned of the __copay categories depending on
the level of need. - questions and answers-C. FOUR
A request to the plan to the plan from a member or provider for a formal review of an Action
(Denial) or
Adverse Plan Determination (medicare) is a/an: - questions and answers-a.APPEAL
All prescription drug plans (PDPs) will continue to offer $0 Tier 1 preferred cost-sharing through
Express Scripts pharmacy (mail order). - questions and answers-TRUE
All prescription drug plans (PDPs) will feature a $0 Tier 1 benefit when filled at preferred
pharmacies. - questions and answers-TRUE
, All Prescription Drug Plans (PDPs) will offer a $__ copay for most Part D preventive Vaccines,
regardless of which network pharmacy is used by members. - questions and answers-ZERO
Although options for capturing and submitting SOAs vary by health plan, wellcare accepts SOAs
in which of the following methods? - questions and answers-ALL OF THESE
An LEP is assessed by CMS when a member goes___days or longer without creditable
prescription drug
coverage after they become Medicare-eligible. - questions and answers-B. 63 DAYS
An SEP is a period outside of the ICEP, AEP, or MA OEP when beneficiaries can enroll based
solely on life events that qualify for an SEP period. - questions and answers-TRUE
Any request or distribution of PH should contain only the minimum amount of PH required to
complete the intended task - questions and answers-TRUE
Ascend is a fast, easy, and compliant way for brokers/agents to submit agent-assisted electronic
enrollments. - questions and answers-TRUE
At the end of this course, there will be a Mastery Exam. Agents must achieve a passing score of
85% or higher to successfully complete this course. - questions and answers-TRUE
Beneficiary-facing marketing materials for multiple MA organizations or plans must be submitted
to the HPMS Marketing Module by the third-party marketing organization (TPMO) no later than
30 days of use. - questions and answers-FALSE
Broker/Agents can access and download enrollment materials through CustomPoint. - questions
and answers-TRUE
Broker/Agents can access the following resources under the Shared Resources section in
Centene Workbench - questions and answers-ALL OF THESE
Broker/Agents can submit a support ticket online through their Centene Workbench portal -
questions and answers-TRUE
Broker/Agents MUST complete a Wellcare contract recertification case in Centene Workbench
(CWB) every two years. - questions and answers-FALSE
Brokers/agents may be investigated after being suspected of noncompliant activity reported
through a: - questions and answers-a. Compliant tracking module (CTM)
b. Grievance
c. secret shop finding.
___Events are designed to inform the people who attend about Medicare Advantage,
Prescription Drug,
or other Medicare programs without going into the specifics of a particular carrier. - questions
and answers-EDUCATIONAL
___Prescription drug plans (PDPs) will be offered across all 50 US states and Washington DC -
questions and answers-THREE
A broker/ agent who has never had any verbal warnings cannot be issued a corrective action
plan. - questions and answers-FALSE
A broker/agent may be terminated for cause if they fail to comply with compliance investigation,
encourage others to avoid the compliance interview process, or fail to provide truthful complete
information. - questions and answers-TRUE
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. - questions and answers-60
A Health Risk Assessment (HRA): - questions and answers-a. Provides physiscians with an
overview of a member's health status.
B. help us understand the
unique health situation og each of our members and allows us to make sure they receive the
services that meet their needs.
c. is an important part of our quality initiative, directly
impacting our star ratings.
D. ALL OF THESE (CORRECT)
A Low-income subsidy (LIS) member will be assigned of the __copay categories depending on
the level of need. - questions and answers-C. FOUR
A request to the plan to the plan from a member or provider for a formal review of an Action
(Denial) or
Adverse Plan Determination (medicare) is a/an: - questions and answers-a.APPEAL
All prescription drug plans (PDPs) will continue to offer $0 Tier 1 preferred cost-sharing through
Express Scripts pharmacy (mail order). - questions and answers-TRUE
All prescription drug plans (PDPs) will feature a $0 Tier 1 benefit when filled at preferred
pharmacies. - questions and answers-TRUE
, All Prescription Drug Plans (PDPs) will offer a $__ copay for most Part D preventive Vaccines,
regardless of which network pharmacy is used by members. - questions and answers-ZERO
Although options for capturing and submitting SOAs vary by health plan, wellcare accepts SOAs
in which of the following methods? - questions and answers-ALL OF THESE
An LEP is assessed by CMS when a member goes___days or longer without creditable
prescription drug
coverage after they become Medicare-eligible. - questions and answers-B. 63 DAYS
An SEP is a period outside of the ICEP, AEP, or MA OEP when beneficiaries can enroll based
solely on life events that qualify for an SEP period. - questions and answers-TRUE
Any request or distribution of PH should contain only the minimum amount of PH required to
complete the intended task - questions and answers-TRUE
Ascend is a fast, easy, and compliant way for brokers/agents to submit agent-assisted electronic
enrollments. - questions and answers-TRUE
At the end of this course, there will be a Mastery Exam. Agents must achieve a passing score of
85% or higher to successfully complete this course. - questions and answers-TRUE
Beneficiary-facing marketing materials for multiple MA organizations or plans must be submitted
to the HPMS Marketing Module by the third-party marketing organization (TPMO) no later than
30 days of use. - questions and answers-FALSE
Broker/Agents can access and download enrollment materials through CustomPoint. - questions
and answers-TRUE
Broker/Agents can access the following resources under the Shared Resources section in
Centene Workbench - questions and answers-ALL OF THESE
Broker/Agents can submit a support ticket online through their Centene Workbench portal -
questions and answers-TRUE
Broker/Agents MUST complete a Wellcare contract recertification case in Centene Workbench
(CWB) every two years. - questions and answers-FALSE
Brokers/agents may be investigated after being suspected of noncompliant activity reported
through a: - questions and answers-a. Compliant tracking module (CTM)
b. Grievance
c. secret shop finding.
