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Examen

2024 WELLCARE ACT MASTERY EXAM – COMPLETE VERIFIED QUESTIONS AND ANSWERS FOR BROKER/AGENT CERTIFICATION

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1. 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 Д (Correct Answer) ,)‘f˙’ Rationale: Compliance investigations require full cooperation from brokers/agents. Responding promptly, answering truthfully, and providing necessary documentation are essential to ensure a thorough and fair investigation. 2. Centene requires all contracted brokers/agents to read, understand, and agree to Centene's Business Ethics and Code of Conduct Policy. Д True Д (Correct Answer) False ˙’,)f‘ Rationale: Centene enforces strict compliance policies to ensure ethical business practices. Agents must acknowledge and adhere to these policies as part of their contractual obligations. 3. Communication of PHI (Protected Health Information) can be: (Select all that apply.) a. Written b. Electronic c. Verbal Д a, b, c Д (Correct Answer) ˙’, ‘f) Rationale: PHI can be communicated in various formats, including written (paper or fax), electronic (email or secure systems), and verbal (phone or in-person conversations). However, all PHI must be handled securely to comply with HIPAA regulations. 4. Wellcare does not need to be informed of all marketing/sales events at which plans or materials will be presented or distributed (Formal s Informal). True Д False Д (Correct Answer) ) ‘ ,f˙’ Rationale: Wellcare must be notified of all marketing and sales events to ensure compliance with CMS (Centers for Medicare C Medicaid Services) regulations and maintain transparency in plan promotion. 5. Enrollment applications must be received by Wellcare no later than calendar day(s) following receipt from the beneficiary. a. 1 Д (Correct Answer) b. 3 c. 5 d. 7 ˙ )f‘ , ’ Rationale: Wellcare requires enrollment applications to be submitted within 1 calendar day of receiving them from a beneficiary to ensure timely processing and compliance with CMS enrollment guidelines. 6. Ascend is a fast, easy, and compliant way for brokers/agents to submit

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2024 Wellcare ACT Mastery
Grado
2024 Wellcare ACT Mastery

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Subido en
31 de mayo de 2025
Número de páginas
27
Escrito en
2024/2025
Tipo
Examen
Contiene
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2024 WELLCARE ACT MASTERY EXAM –
COMPLETE VERIFIED QUESTIONS AND
ANSWERS FOR BROKER/AGENT
CERTIFICATION
[Document subtitle]

, 2024 Wellcare ACT Mastery Exam: Comprehensive
Broker Certification, Compliance, and Enrollment
Training Guide

1. 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 Д (Correct Answer)

)‘f˙’, Rationale: Compliance investigations require full cooperation from brokers/agents.
Responding promptly, answering truthfully, and providing necessary documentation are
essential to ensure a thorough and fair investigation.



2. Centene requires all contracted brokers/agents to read, understand, and agree to
Centene's Business Ethics and Code of Conduct Policy.

Д True Д (Correct Answer)
False

’,)f‘˙ Rationale: Centene enforces strict compliance policies to ensure ethical business
practices. Agents must acknowledge and adhere to these policies as part of their
contractual obligations.



3. Communication of PHI (Protected Health Information) can be: (Select all that apply.)

a. Written
b. Electronic
c. Verbal
Д a, b, c Д (Correct Answer)




[1]

, ’,‘f)˙ Rationale: PHI can be communicated in various formats, including written (paper or
fax), electronic (email or secure systems), and verbal (phone or in-person conversations).
However, all PHI must be handled securely to comply with HIPAA regulations.



4. Wellcare does not need to be informed of all marketing/sales events at which plans
or materials will be presented or distributed (Formal s Informal).

True
Д False Д (Correct Answer)

) Rationale: Wellcare must be notified of all marketing and sales events to ensure


,

compliance with CMS (Centers for Medicare C Medicaid Services) regulations and
maintain transparency in plan promotion.



5. Enrollment applications must be received by Wellcare no later than calendar
day(s) following receipt from the beneficiary.

a. 1 Д (Correct Answer)
b. 3
c. 5
d. 7

˙ )f‘ , ’ Rationale: Wellcare requires enrollment applications to be submitted within 1
calendar day of receiving them from a beneficiary to ensure timely processing and
compliance with CMS enrollment guidelines.



6. Ascend is a fast, easy, and compliant way for brokers/agents to submit agent-
assisted electronic enrollments.

Д True Д (Correct Answer)
False

˙ationale: The Ascend platform is designed to simplify and streamline electronic
f‘)’R
enrollments while ensuring CMS compliance, making it a preferred tool for Wellcare
brokers and agents.




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