2023 WELLCARE MASTERY TEST ACTUAL EXAM 8 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |AGRADE

2023 WELLCARE MASTERY TEST ACTUAL EXAM 8 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |AGRADE During an appointment, you may not discuss any products not agreed to in advance by the beneficiary. a. True b. False - ANSWER- True When a paper SOA form is used, it must be completed __________ hosting the sales presentation. a. Prior to b. During c. After - ANSWER- A. Prior to Brokers/Agents can submit a support ticket online through their Centene Workbench portal. Select one: True False - ANSWER- True Wellcare does not need to be informed of all marketing/sales events at which plans or materials will be presented or distributed (Formal & Informal). Select one: True False - ANSWER- False Which of the following actions are you required to do when contacted regarding an allegation of noncompliant activity? a. Speak with the investigator as quickly as possible. b. Answer all questions honestly and completely. c. Offer information and documents important to the investigation. d. All of the above - ANSWER- D. All of the above Key areas you as a broker/agent have control over and impact upon regarding Star Ratings for quality are: a. Member Satisfaction/Experience b. Complaints c. Rapid Disenrollment d. All of the above - ANSWER- D. All of the aboveNoting the correct enrollment period on enrollment applications helps in preventing delayed enrollment processing. Select one: True False - ANSWER- True Health plan fax numbers vary for health plans that offer fax enrollment submissions. Select one: True False - ANSWER- True Centene requires all contracted brokers/agents to read, understand, and agree to Centene's Business Ethics and Code of Conduct Policy. Select one: True False - 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. a. 30 b. 45 c. 60 d. 90 - ANSWER- C. 60 Any request or distribution of PHI should contain only the minimum amount of PHI required to complete the intended task. Select one: True False - ANSWER- True Beneficiary-facing content that includes generic or plan-specific product or benefit information must be submitted for review and CMS submission, as well as acceptance or approval, prior to distribution. Select one: True False - ANSWER- TrueA broker/agent may be terminated for cause if they fail to comply with a compliance investigation, encourage others to avoid the compliance interview process, or fail to provide truthful or complete information. Select one: True False - 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. Select one: True False - ANSWER- True A Health Risk Assessment (HRA) can be completed for C-SNP and D-SNP plans only, before the enrollment application process in Ascend through the Value Based Enrollment (VBE) portal. Select one: True False - ANSWER- False What are some examples of what can trigger a beneficiary complaint? (Select all that apply.) a. Did not consent to enroll in the plan. b. Received incorrect plan benefit information or were dissatisfied with plan benefits. c. Had enrollment/disenrollment issues (e.g., disenrollment/cancellation requests, late enrollment penalty, loss of entitlement). d. Were misled about which providers were in-network. - ANSWER- All (A,B,C,D) A broker/agent who has never had any verbal warnings cannot be issued a Corrective Action Plan. Select one: True False - ANSWER- False Prior to completing the enrollment form, you should always confirm the beneficiary's primary care physician (PCP) and/or specialists. Select one: True False - ANSWER- TrueThe _________ plan is expected to have one of the lowest premiums in the country! a. Classic b. Value Plus c. Value Script - ANSWER- C. Value script Wellcare added ___ counties to their footprint for 2023. a. 122 b. 209 c. 284 d. 327 - ANSWER- B. 209 The Wellcare preferred pharmacy network includes Walgreens, CVS, and many grocery chains in 2023. Select one: True False - ANSWER- True ____ PDPs will be offered across all 50 U.S. states and Washington, D.C. a. Two b. Three c. Four d. Five - ANSWER- B. Three All PDPs will continue to offer $0 tier 1 preferred cost-sharing through CVS Medication Home Delivery (Mail Order). Select one: True False - ANSWER- True There are ___ LIS copay categories that could be assigned to a member, depending on the level of need. a. two b. three c. four d. five - ANSWER- C. Four Which standalone Prescription Drug Plan is best for a dual-eligible chooser? a. Value Script (not correct) b. Value Plusc. Classic - ANSWER- C. Classic For 2023, Ascension Complete added 27 new counties to their footprint. Select one: True False - ANSWER- True For PDP Medication Home Delivery, the ____ plan will continue to offer a discount for 90-day tier 2, tier 3 and tier 6 prescriptions. a. Classic b. Value Plus c. Value Script - ANSWER- B. Value plus Centene's 2023 product expansion represents a __% increase from 2022. a. 1 b. 2 c. 3 d. 5 - ANSWER- C. 3 Centene has new PPO D-SNP product expansion in CT, IN, KS, KY, MS, OH, OK, PA, SC, and a new HMO D-SNP in LA. Select one: True False - ANSWER- True Value Script and Value Plus PDP products have a ___-tier formulary structure for 2023. a. 3 b. 4 c. 5 d. 6 - ANSWER- D. 6 Wellcare offers a range of Medicare plans to provide members with affordable access to: a. Doctors b. Hospitals c. Specialists d. All of the above - ANSWER- D. All of the Above