2023 Wellcare ACT Mastery Certification Exam Questions And Answers

By selecting the correct provider during the enrollment process, you can: - ANSWER All of the above A grievance request, or any evidence concerning a grievance, must be fi led 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. – ANSWER 60 The Single Sign-On Portal provides access to several applications, including Centene Workbench. – ANSWER True 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. - ANSWER True Brokers/Agents may be investigated after being suspected of noncompliant activity reported through a: - ANSWER -Complaint Tracking Module (CTM) -Grievance -Secret Shop Finding The NEW online Centene Workbench self-service portal enables you to: - ANSWER All of the above When discussing prescription drug coverage, you should: - ANSWER -Explain how to use the formulary to look up limitations and exclusions (e.g., step therapy, quantity limits). -Confirm coverage of the beneficiary's current and/or anticipated prescriptions. -Explain formulary tiers as well as drug copayment amounts. -For drugs that are not covered by the new plan, explain the Transition Fill program and how to request a coverage exception.