WELLCARE ACT CELENE MASTERY QUESTIONS &
ANSWERS
You can help prevent grievances by: (Select all that apply.) - Answer -a. Always
confirming availability of the beneficiary's primary and specialist providers by using the
provider search tool available on the plan's website.
b. Always using plan materials to clearly explain plan benefits and cost (including
medications) and check for understanding.
c. Always confirming a beneficiary's intent to enroll before accepting their enrollment
application.
(All of the above)
Which of the following is not an example of Protected Health Information (PHI)? -
Answer -Library card
When enrolling a D-SNP beneficiary, be sure to verify plan enrollment eligibility and that
the Medicare Savings Program (MSP) level is eligible for the requested plan. - Answer -
True
Member PHI can be stored on an external hard drive or a cloud storage service like
Google Drive or Apple Cloud. - Answer -False
Medicare Star Ratings and performance are at the forefront of Wellcare's quality
strategy. Wellcare's quality focus consists of six drivers. Which of the following is not a
Wellcare quality driver? - Answer -Member Payments - (The Six Drivers are Member
Service, Serving Government Customers, Selection and Enrollment, Reputation,
Requirement of Participation, Bonus Payment.)
Agents must meet all required contracting, training, and certification requirements to be
eligible to sell Wellcare's Medicare products. - Answer -True
The information contained within ACT will equip agents to certify, market, and sell which
health plans? - Answer -All of the above (Ascension Complete and Wellcare)
Which of the following statements about completing telephonic enrollments is FALSE? -
Answer -Must include most of the required elements necessary to complete the
enrollment.
Noting the correct enrollment period on enrollment applications helps in preventing
delayed enrollment processing. - Answer -True
Which of the following is not considered a grievance? - Answer -A dispute of the appeal
of an organization determination, coverage determination or a Late Enrollment Penalty
(LEP) determination.
ANSWERS
You can help prevent grievances by: (Select all that apply.) - Answer -a. Always
confirming availability of the beneficiary's primary and specialist providers by using the
provider search tool available on the plan's website.
b. Always using plan materials to clearly explain plan benefits and cost (including
medications) and check for understanding.
c. Always confirming a beneficiary's intent to enroll before accepting their enrollment
application.
(All of the above)
Which of the following is not an example of Protected Health Information (PHI)? -
Answer -Library card
When enrolling a D-SNP beneficiary, be sure to verify plan enrollment eligibility and that
the Medicare Savings Program (MSP) level is eligible for the requested plan. - Answer -
True
Member PHI can be stored on an external hard drive or a cloud storage service like
Google Drive or Apple Cloud. - Answer -False
Medicare Star Ratings and performance are at the forefront of Wellcare's quality
strategy. Wellcare's quality focus consists of six drivers. Which of the following is not a
Wellcare quality driver? - Answer -Member Payments - (The Six Drivers are Member
Service, Serving Government Customers, Selection and Enrollment, Reputation,
Requirement of Participation, Bonus Payment.)
Agents must meet all required contracting, training, and certification requirements to be
eligible to sell Wellcare's Medicare products. - Answer -True
The information contained within ACT will equip agents to certify, market, and sell which
health plans? - Answer -All of the above (Ascension Complete and Wellcare)
Which of the following statements about completing telephonic enrollments is FALSE? -
Answer -Must include most of the required elements necessary to complete the
enrollment.
Noting the correct enrollment period on enrollment applications helps in preventing
delayed enrollment processing. - Answer -True
Which of the following is not considered a grievance? - Answer -A dispute of the appeal
of an organization determination, coverage determination or a Late Enrollment Penalty
(LEP) determination.
