WellCare Mastery Test 2024 Questions And Answers A+ Graded

Low-Income Subsidy (LIS), which is often referred to as Extra Help, reduces all Part D plan premiums. - Answer-False Which is an example of a top beneficiary complaint that affects Star Ratings? - Answer-The beneficiary did not understand that enrolling in a Wellcare plan would change their current Medicare Advantage plan. Providers may create co-branded marketing pieces using the Wellcare name and logo, as long as they are using the current, approved logo. - Answer-False An agent who has never had any verbal warnings cannot be issued a Corrective Action Plan. - Answer-False Once the enrollment is completed, you can save a copy of the application for your reference. - Answer-False Noting the correct enrollment period on enrollment applications helps in preventing delayed enrollment processing. - Answer-True When completing an application, you should ensure that you enter the provider ID of a specialist and not a primary care provider (PCP). - Answer-False Agents may be investigated after being suspected of noncompliant activity reported through a: - Answer-Complaint Tracking Module (CTM), Grievance, and Secret Shop Finding Which of the following statements about completing telephonic enrollments is FALSE? - AnswerMust include most of the required elements necessary to complete the enrollment. 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 When completing an enrollment, be sure to use the correct enrollment application for the desired plan year. - Answer-TrueAn 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. - Answer-True Members who fail to pay the required premiums before the end of the grace period (Wellcare has a three-month grace period) will be terminated. - Answer-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. - Answer-60 What are some examples of steps that can be taken when safeguarding and securing PHI and PII? - Answer-Shred documents that contain PHI or PII using appropriate means. Never leave laptops, PHI, or PII in an unattended vehicle. Do not include PHI or PII in the subject line or body of an email. Secure emails that contain PHI or PII. When explaining the provider network for D-SNPs and C-SNPs: - Answer-Avoid submitting applications with no primary care provider (PCP) to assist these higher-risk members. If a member is not connected to a primary care provider (PCP), we should always encourage and assist with connecting them with an in-network doctor. An LEP is assessed by CMS when a member goes ______ days or longer without creditable prescription drug coverage after they become Medicare-eligible. - Answer-63 days