Wellcare Exam 2024 exam with correct
answers
A vrequest vto vthe vplan vto vthe vplan vfrom va vmember vor vprovider vfor va vformal vreview vof van vAction
v(Denial) vor v
Adverse vPlan vDetermination v(medicare) vis va/an: v- vcorrect vanswera.APPEAL
A vgrievance vrequest, vor vany vevidence vconcerning va vgrievance, vmust vbe vfiled vorally vor vin vwriting vno
vlater vthan v__ vcalendar vdays vfrom vthe vdate vof vthe vevent vor vthe vdate vthe vmember vis vmade vaware vof
vthe vissue. v- vcorrect vanswer60
An vLEP vis vassessed vby vCMS vwhen va vmember vgoes___days vor vlonger vwithout vcreditable vprescription
vdrug v
coverage vafter vthey vbecome vMedicare-eligible. v- vcorrect vanswerB. v63 vDAYS
Ascend vis va vfast, veasy, vand vcompliant vway vfor vbrokers/agents vto vsubmit vagent-assisted velectronic v
enrollments. v- vcorrect vanswerTRUE
A vHealth vRisk vAssessment v(HRA): v- vcorrect vanswera. vProvides vphysiscians vwith van voverview vof va
vmember's vhealth vstatus. v
B. vhelp vus vunderstand vthe v
unique vhealth vsituation vog veach vof vour vmembers vand vallows vus vto vmake vsure vthey vreceive vthe v
services vthat vmeet vtheir vneeds.
c. vis van vimportant vpart vof vour vquality vinitiative, vdirectly v
impacting vour vstar vratings. v
D. vALL vOF vTHESE v(CORRECT)
A vbroker/agent vmay vbe vterminated vfor vcause vif vthey vfail vto vcomply vwith vcompliance vinvestigation,
vencourage vothers vto vavoid vthe vcompliance vinterview vprocess, vor vfail vto vprovide vtruthful vcomplete
vinformation. v- vcorrect vanswerTRUE
, A vbroker/ vagent vwho vhas vnever vhad vany vverbal vwarnings vcannot vbe vissued va vcorrective vaction vplan. v-
vcorrect vanswerFALSE
A vLow-income vsubsidy v(LIS) vmember vwill vbe vassigned vof vthe v__copay vcategories vdepending von vthe
vlevel vof vneed. v- vcorrect vanswerC. vFOUR
All vprescription vdrug vplans v(PDPs) vwill vfeature va v$0 vTier v1 vbenefit vwhen vfilled vat vpreferred vpharmacies.
v- vcorrect vanswerTRUE
All vprescription vdrug vplans v(PDPs) vwill vcontinue vto voffer v$0 vTier v1 vpreferred vcost-sharing vthrough
vExpress vScripts vpharmacy v(mail vorder). v- vcorrect vanswerTRUE
All vPrescription vDrug vPlans v(PDPs) vwill voffer va v$__ vcopay vfor vmost vPart vD vpreventive vVaccines,
vregardless vof vwhich vnetwork vpharmacy vis vused vby vmembers. v- vcorrect vanswerZERO
At vthe vend vof vthis vcourse, vthere vwill vbe va vMastery vExam. vAgents vmust vachieve va vpassing vscore vof v85%
vor vhigher vto vsuccessfully vcomplete vthis vcourse. v- vcorrect vanswerTRUE
Although voptions vfor vcapturing vand vsubmitting vSOAs vvary vby vhealth vplan, vwellcare vaccepts vSOAs vin
vwhich vof vthe vfollowing vmethods? v- vcorrect vanswerALL vOF vTHESE
Any vrequest vor vdistribution vof vPH vshould vcontain vonly vthe vminimum vamount vof vPH vrequired vto
vcomplete vthe vintended vtask v- vcorrect vanswerTRUE
An vSEP vis va vperiod voutside vof vthe vICEP, vAEP, vor vMA vOEP vwhen vbeneficiaries vcan venroll vbased vsolely von
vlife vevents vthat vqualify vfor van vSEP vperiod. v- vcorrect vanswerTRUE
Beneficiary-facing vmarketing vmaterials vfor vmultiple vMA vorganizations vor vplans vmust vbe vsubmitted vto
vthe vHPMS vMarketing vModule vby vthe vthird-party vmarketing vorganization v(TPMO) vno vlater vthan v30 vdays
vof vuse. v- vcorrect vanswerFALSE
answers
A vrequest vto vthe vplan vto vthe vplan vfrom va vmember vor vprovider vfor va vformal vreview vof van vAction
v(Denial) vor v
Adverse vPlan vDetermination v(medicare) vis va/an: v- vcorrect vanswera.APPEAL
A vgrievance vrequest, vor vany vevidence vconcerning va vgrievance, vmust vbe vfiled vorally vor vin vwriting vno
vlater vthan v__ vcalendar vdays vfrom vthe vdate vof vthe vevent vor vthe vdate vthe vmember vis vmade vaware vof
vthe vissue. v- vcorrect vanswer60
An vLEP vis vassessed vby vCMS vwhen va vmember vgoes___days vor vlonger vwithout vcreditable vprescription
vdrug v
coverage vafter vthey vbecome vMedicare-eligible. v- vcorrect vanswerB. v63 vDAYS
Ascend vis va vfast, veasy, vand vcompliant vway vfor vbrokers/agents vto vsubmit vagent-assisted velectronic v
enrollments. v- vcorrect vanswerTRUE
A vHealth vRisk vAssessment v(HRA): v- vcorrect vanswera. vProvides vphysiscians vwith van voverview vof va
vmember's vhealth vstatus. v
B. vhelp vus vunderstand vthe v
unique vhealth vsituation vog veach vof vour vmembers vand vallows vus vto vmake vsure vthey vreceive vthe v
services vthat vmeet vtheir vneeds.
c. vis van vimportant vpart vof vour vquality vinitiative, vdirectly v
impacting vour vstar vratings. v
D. vALL vOF vTHESE v(CORRECT)
A vbroker/agent vmay vbe vterminated vfor vcause vif vthey vfail vto vcomply vwith vcompliance vinvestigation,
vencourage vothers vto vavoid vthe vcompliance vinterview vprocess, vor vfail vto vprovide vtruthful vcomplete
vinformation. v- vcorrect vanswerTRUE
, A vbroker/ vagent vwho vhas vnever vhad vany vverbal vwarnings vcannot vbe vissued va vcorrective vaction vplan. v-
vcorrect vanswerFALSE
A vLow-income vsubsidy v(LIS) vmember vwill vbe vassigned vof vthe v__copay vcategories vdepending von vthe
vlevel vof vneed. v- vcorrect vanswerC. vFOUR
All vprescription vdrug vplans v(PDPs) vwill vfeature va v$0 vTier v1 vbenefit vwhen vfilled vat vpreferred vpharmacies.
v- vcorrect vanswerTRUE
All vprescription vdrug vplans v(PDPs) vwill vcontinue vto voffer v$0 vTier v1 vpreferred vcost-sharing vthrough
vExpress vScripts vpharmacy v(mail vorder). v- vcorrect vanswerTRUE
All vPrescription vDrug vPlans v(PDPs) vwill voffer va v$__ vcopay vfor vmost vPart vD vpreventive vVaccines,
vregardless vof vwhich vnetwork vpharmacy vis vused vby vmembers. v- vcorrect vanswerZERO
At vthe vend vof vthis vcourse, vthere vwill vbe va vMastery vExam. vAgents vmust vachieve va vpassing vscore vof v85%
vor vhigher vto vsuccessfully vcomplete vthis vcourse. v- vcorrect vanswerTRUE
Although voptions vfor vcapturing vand vsubmitting vSOAs vvary vby vhealth vplan, vwellcare vaccepts vSOAs vin
vwhich vof vthe vfollowing vmethods? v- vcorrect vanswerALL vOF vTHESE
Any vrequest vor vdistribution vof vPH vshould vcontain vonly vthe vminimum vamount vof vPH vrequired vto
vcomplete vthe vintended vtask v- vcorrect vanswerTRUE
An vSEP vis va vperiod voutside vof vthe vICEP, vAEP, vor vMA vOEP vwhen vbeneficiaries vcan venroll vbased vsolely von
vlife vevents vthat vqualify vfor van vSEP vperiod. v- vcorrect vanswerTRUE
Beneficiary-facing vmarketing vmaterials vfor vmultiple vMA vorganizations vor vplans vmust vbe vsubmitted vto
vthe vHPMS vMarketing vModule vby vthe vthird-party vmarketing vorganization v(TPMO) vno vlater vthan v30 vdays
vof vuse. v- vcorrect vanswerFALSE
