Wellcare fgExam fg2024
Study fgonline fgat
fghttps://quizlet.com/_dth3ux
1. A fgrequest fgto fgthe fgplan fgto fgthe fgplan fgfrom fga fgmember fgor fgprovider fgfor
fga fgformal fgreview fgof fgan fg Action fg(Denial) fgor
Adverse fgPlan fgDetermination fg(medicare) fgis fga/an:: fga.APPEAL
2. A fggrievance fgrequest, fgor fgany fgevidence fgconcerning fga fggrievance, fgmust fgbe
fgfiled fgorally fgor fgin fgwriting fgno fglater fgthan fg calendar fgdays fgfrom fgthe fgdate
fgof fgthe fgevent fgor fgthe fgdate fgthe fgmember fgis fgmade fgaware fgof fgthe fgissue.:
fg60
3. An fgLEP fgis fgassessed fgby fgCMS fgwhen fga fgmember fggoes days fgor fglonger
fgwithout fgcreditable fgprescription fgdrug
coverage fgafter fgthey fgbecome fgMedicare-eligible.: fgB. fg63 fgDAYS
4. Ascend fgis fga fgfast, fgeasy, fgand fgcompliant fgway fgfor fgbrokers/agents fgto
fgsubmit fgagent-assisted fgelectronic
enrollments.: fgTRUE
5. A fgHealth fgRisk fgAssessment fg(HRA):: fga. fgProvides fgphysiscians fgwith fgan
fgoverview fgof fga fgmember's fghealth fgstatus.
B. fghelp fgus fgunderstand fgthe
unique fghealth fgsituation fgog fgeach fgof fgour fgmembers fgand fgallows fgus fgto fgmake fgsure
fgthey fgreceive fgthe
services fgthat fgmeet fgtheir fgneeds.
c. fgis fgan fgimportant fgpart fgof fgour fgquality fginitiative, fgdirectly
fgimpacting fgour fgstar fgratings.
D. fgALL fgOF fgTHESE fg(CORRECT)
6. A fgbroker/agent fgmay fgbe fgterminated fgfor fgcause fgif fgthey fgfail fgto fgcomply
fgwith fgcompliance fginvestigation, fgencourage fgothers fgto fgavoid fgthe fgcompliance
fginterview fgprocess, fgor fgfail fgto fgprovide fgtruthful fgcomplete fginformation.:
fgTRUE
7. A fgbroker/ fgagent fgwho fghas fgnever fghad fgany fgverbal fgwarnings fgcannot fgbe
fgissued fga fgcorrective fgaction fgplan.: fgFALSE
8. A fgLow-income fgsubsidy fg(LIS) fgmember fgwill fgbe fgassigned fgof fgthe fg
copay fgcate- fggories fgdepending fgon fgthe fglevel fgof fgneed.: fgC. fgFOUR
9. All fgprescription fgdrug fgplans fg(PDPs) fgwill fgfeature fga fg$0fgTier fg1 fgbenefit fgwhen
fgfilled fgat fgpreferred fgpharmacies.: fgTRUE
10. All fgprescription fgdrug fgplans fg(PDPs) fgwill fgcontinue fgto fgoffer fg$0fgTier fg1
fgpreferred fgcost-sharing fgthrough fgExpress fgScripts fgpharmacy fg(mail
fgorder).: fgTRUE
11. All fgPrescription fgDrug fgPlans fg(PDPs) fgwill fgoffer fga fg$ copay fgfor
fgmost fgPart fgD fgpreventive fgVaccines, fgregardless fgof fgwhich fgnetwork
fgpharmacy fgis fgused fgby fgmembers.: fgZERO
12. At fgthe fgend fgof fgthis fgcourse, fgthere fgwill fgbe fga fgMastery fgExam.
fgAgents fgmust fgachieve fga fgpassing fgscore fgof fg85% fgor fghigher fgto
1 fg/
fg12
, Wellcare fgExam fg2024
Study fgonline fgat
fghttps://quizlet.com/_dth3ux
fgsuccessfully fgcomplete fgthis fgcourse.: fgTRUE
2 fg/
fg12
Study fgonline fgat
fghttps://quizlet.com/_dth3ux
1. A fgrequest fgto fgthe fgplan fgto fgthe fgplan fgfrom fga fgmember fgor fgprovider fgfor
fga fgformal fgreview fgof fgan fg Action fg(Denial) fgor
Adverse fgPlan fgDetermination fg(medicare) fgis fga/an:: fga.APPEAL
2. A fggrievance fgrequest, fgor fgany fgevidence fgconcerning fga fggrievance, fgmust fgbe
fgfiled fgorally fgor fgin fgwriting fgno fglater fgthan fg calendar fgdays fgfrom fgthe fgdate
fgof fgthe fgevent fgor fgthe fgdate fgthe fgmember fgis fgmade fgaware fgof fgthe fgissue.:
fg60
3. An fgLEP fgis fgassessed fgby fgCMS fgwhen fga fgmember fggoes days fgor fglonger
fgwithout fgcreditable fgprescription fgdrug
coverage fgafter fgthey fgbecome fgMedicare-eligible.: fgB. fg63 fgDAYS
4. Ascend fgis fga fgfast, fgeasy, fgand fgcompliant fgway fgfor fgbrokers/agents fgto
fgsubmit fgagent-assisted fgelectronic
enrollments.: fgTRUE
5. A fgHealth fgRisk fgAssessment fg(HRA):: fga. fgProvides fgphysiscians fgwith fgan
fgoverview fgof fga fgmember's fghealth fgstatus.
B. fghelp fgus fgunderstand fgthe
unique fghealth fgsituation fgog fgeach fgof fgour fgmembers fgand fgallows fgus fgto fgmake fgsure
fgthey fgreceive fgthe
services fgthat fgmeet fgtheir fgneeds.
c. fgis fgan fgimportant fgpart fgof fgour fgquality fginitiative, fgdirectly
fgimpacting fgour fgstar fgratings.
D. fgALL fgOF fgTHESE fg(CORRECT)
6. A fgbroker/agent fgmay fgbe fgterminated fgfor fgcause fgif fgthey fgfail fgto fgcomply
fgwith fgcompliance fginvestigation, fgencourage fgothers fgto fgavoid fgthe fgcompliance
fginterview fgprocess, fgor fgfail fgto fgprovide fgtruthful fgcomplete fginformation.:
fgTRUE
7. A fgbroker/ fgagent fgwho fghas fgnever fghad fgany fgverbal fgwarnings fgcannot fgbe
fgissued fga fgcorrective fgaction fgplan.: fgFALSE
8. A fgLow-income fgsubsidy fg(LIS) fgmember fgwill fgbe fgassigned fgof fgthe fg
copay fgcate- fggories fgdepending fgon fgthe fglevel fgof fgneed.: fgC. fgFOUR
9. All fgprescription fgdrug fgplans fg(PDPs) fgwill fgfeature fga fg$0fgTier fg1 fgbenefit fgwhen
fgfilled fgat fgpreferred fgpharmacies.: fgTRUE
10. All fgprescription fgdrug fgplans fg(PDPs) fgwill fgcontinue fgto fgoffer fg$0fgTier fg1
fgpreferred fgcost-sharing fgthrough fgExpress fgScripts fgpharmacy fg(mail
fgorder).: fgTRUE
11. All fgPrescription fgDrug fgPlans fg(PDPs) fgwill fgoffer fga fg$ copay fgfor
fgmost fgPart fgD fgpreventive fgVaccines, fgregardless fgof fgwhich fgnetwork
fgpharmacy fgis fgused fgby fgmembers.: fgZERO
12. At fgthe fgend fgof fgthis fgcourse, fgthere fgwill fgbe fga fgMastery fgExam.
fgAgents fgmust fgachieve fga fgpassing fgscore fgof fg85% fgor fghigher fgto
1 fg/
fg12
, Wellcare fgExam fg2024
Study fgonline fgat
fghttps://quizlet.com/_dth3ux
fgsuccessfully fgcomplete fgthis fgcourse.: fgTRUE
2 fg/
fg12
