WellCare Mastery Test 2024 exam with
correct answers
Low-Income vSubsidy v(LIS), vwhich vis voften vreferred vto vas vExtra vHelp, vreduces vall vPart vD vplan vpremiums.
v- vcorrect vanswerFalse
Which vis van vexample vof va vtop vbeneficiary vcomplaint vthat vaffects vStar vRatings? v- vcorrect vanswerThe
vbeneficiary vdid vnot vunderstand vthat venrolling vin va vWellcare vplan vwould vchange vtheir vcurrent vMedicare
vAdvantage vplan.
Providers vmay vcreate vco-branded vmarketing vpieces vusing vthe vWellcare vname vand vlogo, vas vlong vas vthey
vare vusing vthe vcurrent, vapproved vlogo. v- vcorrect vanswerFalse
An vagent vwho vhas vnever vhad vany vverbal vwarnings vcannot vbe vissued va vCorrective vAction vPlan. v- vcorrect
vanswerFalse
Once vthe venrollment vis vcompleted, vyou vcan vsave va vcopy vof vthe vapplication vfor vyour vreference. v-
vcorrect vanswerFalse
Noting vthe vcorrect venrollment vperiod von venrollment vapplications vhelps vin vpreventing vdelayed
venrollment vprocessing. v- vcorrect vanswerTrue
When vcompleting van vapplication, vyou vshould vensure vthat vyou venter vthe vprovider vID vof va vspecialist vand
vnot va vprimary vcare vprovider v(PCP). v- vcorrect vanswerFalse
Agents vmay vbe vinvestigated vafter vbeing vsuspected vof vnoncompliant vactivity vreported vthrough va: v-
vcorrect vanswerComplaint vTracking vModule v(CTM), vGrievance, vand vSecret vShop vFinding
Which vof vthe vfollowing vstatements vabout vcompleting vtelephonic venrollments vis vFALSE? v- vcorrect
vanswerMust vinclude vmost vof vthe vrequired velements vnecessary vto vcomplete vthe venrollment.
, Failure vto vinform va vbeneficiary vthat va vtrusted vprovider vis vout-of-network vor vis vnot vavailable vin vthe
vnewly vselected vplan vcan vcause va vsales vallegation. v- vcorrect vanswerTrue
When vcompleting van venrollment, vbe vsure vto vuse vthe vcorrect venrollment vapplication vfor vthe vdesired
vplan vyear. 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
Members vwho vfail vto vpay vthe vrequired vpremiums vbefore vthe vend vof vthe vgrace vperiod v(Wellcare vhas va
vthree-month vgrace vperiod) vwill vbe vterminated. v- vcorrect vanswerTrue
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
What vare vsome vexamples vof vsteps vthat vcan vbe vtaken vwhen vsafeguarding vand vsecuring vPHI vand vPII? v-
vcorrect vanswerShred vdocuments vthat vcontain vPHI vor vPII vusing vappropriate vmeans.
Never vleave vlaptops, vPHI, vor vPII vin van vunattended vvehicle.
Do vnot vinclude vPHI vor vPII vin vthe vsubject vline vor vbody vof van vemail.
Secure vemails vthat vcontain vPHI vor vPII.
When vexplaining vthe vprovider vnetwork vfor vD-SNPs vand vC-SNPs: v- vcorrect vanswerAvoid vsubmitting
vapplications vwith vno vprimary vcare vprovider v(PCP) vto vassist vthese vhigher-risk vmembers. vIf va vmember vis
vnot vconnected vto va vprimary vcare vprovider v(PCP), vwe vshould valways vencourage vand vassist vwith
vconnecting vthem vwith van vin-network vdoctor.
An vLEP vis vassessed vby vCMS vwhen va vmember vgoes v______ vdays vor vlonger vwithout vcreditable
vprescription vdrug vcoverage vafter vthey vbecome vMedicare-eligible. v- vcorrect vanswer63 vdays
Members vare vno vlonger vrequired vto vpay va vpartial vdeductible vdue vto vthe vInflation vReduction vAct. v-
vcorrect vanswerTrue
correct answers
Low-Income vSubsidy v(LIS), vwhich vis voften vreferred vto vas vExtra vHelp, vreduces vall vPart vD vplan vpremiums.
v- vcorrect vanswerFalse
Which vis van vexample vof va vtop vbeneficiary vcomplaint vthat vaffects vStar vRatings? v- vcorrect vanswerThe
vbeneficiary vdid vnot vunderstand vthat venrolling vin va vWellcare vplan vwould vchange vtheir vcurrent vMedicare
vAdvantage vplan.
Providers vmay vcreate vco-branded vmarketing vpieces vusing vthe vWellcare vname vand vlogo, vas vlong vas vthey
vare vusing vthe vcurrent, vapproved vlogo. v- vcorrect vanswerFalse
An vagent vwho vhas vnever vhad vany vverbal vwarnings vcannot vbe vissued va vCorrective vAction vPlan. v- vcorrect
vanswerFalse
Once vthe venrollment vis vcompleted, vyou vcan vsave va vcopy vof vthe vapplication vfor vyour vreference. v-
vcorrect vanswerFalse
Noting vthe vcorrect venrollment vperiod von venrollment vapplications vhelps vin vpreventing vdelayed
venrollment vprocessing. v- vcorrect vanswerTrue
When vcompleting van vapplication, vyou vshould vensure vthat vyou venter vthe vprovider vID vof va vspecialist vand
vnot va vprimary vcare vprovider v(PCP). v- vcorrect vanswerFalse
Agents vmay vbe vinvestigated vafter vbeing vsuspected vof vnoncompliant vactivity vreported vthrough va: v-
vcorrect vanswerComplaint vTracking vModule v(CTM), vGrievance, vand vSecret vShop vFinding
Which vof vthe vfollowing vstatements vabout vcompleting vtelephonic venrollments vis vFALSE? v- vcorrect
vanswerMust vinclude vmost vof vthe vrequired velements vnecessary vto vcomplete vthe venrollment.
, Failure vto vinform va vbeneficiary vthat va vtrusted vprovider vis vout-of-network vor vis vnot vavailable vin vthe
vnewly vselected vplan vcan vcause va vsales vallegation. v- vcorrect vanswerTrue
When vcompleting van venrollment, vbe vsure vto vuse vthe vcorrect venrollment vapplication vfor vthe vdesired
vplan vyear. 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
Members vwho vfail vto vpay vthe vrequired vpremiums vbefore vthe vend vof vthe vgrace vperiod v(Wellcare vhas va
vthree-month vgrace vperiod) vwill vbe vterminated. v- vcorrect vanswerTrue
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
What vare vsome vexamples vof vsteps vthat vcan vbe vtaken vwhen vsafeguarding vand vsecuring vPHI vand vPII? v-
vcorrect vanswerShred vdocuments vthat vcontain vPHI vor vPII vusing vappropriate vmeans.
Never vleave vlaptops, vPHI, vor vPII vin van vunattended vvehicle.
Do vnot vinclude vPHI vor vPII vin vthe vsubject vline vor vbody vof van vemail.
Secure vemails vthat vcontain vPHI vor vPII.
When vexplaining vthe vprovider vnetwork vfor vD-SNPs vand vC-SNPs: v- vcorrect vanswerAvoid vsubmitting
vapplications vwith vno vprimary vcare vprovider v(PCP) vto vassist vthese vhigher-risk vmembers. vIf va vmember vis
vnot vconnected vto va vprimary vcare vprovider v(PCP), vwe vshould valways vencourage vand vassist vwith
vconnecting vthem vwith van vin-network vdoctor.
An vLEP vis vassessed vby vCMS vwhen va vmember vgoes v______ vdays vor vlonger vwithout vcreditable
vprescription vdrug vcoverage vafter vthey vbecome vMedicare-eligible. v- vcorrect vanswer63 vdays
Members vare vno vlonger vrequired vto vpay va vpartial vdeductible vdue vto vthe vInflation vReduction vAct. v-
vcorrect vanswerTrue
