macellen education agencies

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. Correct answers true Providers may create co-branded marketing pieces using the Wellcare name and logo, as long as they are using the current, approved logo. Correct answers false 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 th...

In 2025, Medicare Advantage Prescription Drug (MAPD) plans will have six formularies with six individual tier structures. Correct answers False Members are no longer required to pay a partial deductible due to the Inflation Reduction Act. Correct answers TRUE The Prescription Drug Plan (PDP) network is expected to include over -_ total pharmacies. Correct answers 60,000 Low-Income Subsidy (LIS) Level 4 is ending and moving to Level 1 as new certifications and recertifications take place...

With the Pharmacy Benefit Manager (PBM) migration to Express Scripts effective 1/1/2024, existing members can continue to use their current ID card 1/1/2024 and beyond. Correct answers False - With the PBM migration to Express Scripts effective 1/1/2024, all existing members will receive a new ID card containing new pharmacy processing information and must use their new ID card starting 1/1/2024. Wellcare's _____ plan is designed for Low-Income Subsidy members. Question 29Select one:a. C...

For Prescription Drug Plan (PDP) Medication home delivery, the ______ plan will continue to offer a discount (2.5x 30-day preferred retail copay) for a 90-day supply of Tier 2 medications. Correct answers Value Plus Members who ha LIS and enroll in a plan other than Wellcare's Classic plan will pay a premium regardless of LIS subsidy status. Correct answers True Wellcare's ___________ plan is designed for Low-|ncome Subsidy (LIS) members. Correct answers Classic Custom Point sales...

All three prescription drug plans (PDPs) will offer a five-tier formulary design Correct answers False All Prescription Drug Plans (PDPs) will feature a $0 Tier 1 benefit when filled at preferred pharmacies Correct answers True For 2025, Wellcare preferred networks include Walgreens, CVS, and some grocery chains Correct answers True For 2025, Wellcare has 43 new plans going to market Correct answers True A low-Income Subsidy (LIS) member could be assigned one of __________copay categ...

An 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 Correct answers answer: True Any request or distribution of PHI should contain only the minimum amount of PHI required to complete the intended task. Correct answers Answer: TRUE A request to the plan from a member or provider for a formal review of an Action (Denial) or Adverse Plan Determination (Medicare) is a/an: Correct answers Answer: Appeal ...

For 2025, Wellcare has 43 new plans going to market. True or False Correct answers True Wellcare's _____ plan is designed for Low-Income Subsidy (LIS) members. Classic Value Plus Value Script Correct answers Classic All Traditional Medicare Advantage Prescription Drug (MAPD) plans with drug coverage include a $0 copay Tier 6 at all in-network pharmacy locations. TRUE FALSE Correct answers True Which of the following statements about CustomPoint® features is FALSE? Access throu...

Enrollment applications must be received by Wellcare no later than ___ calendar day(s) following receipt from the beneficiary. Correct answers 1 Which elements are available as part of Wellcare's Sales Support model? Correct answers All of these Low-Income Subsidy (LIS), which is often referred to as Extra Help, reduces all Part D plan premiums Correct answers False Prior to completing the enrollment form, broker/agents should always confirm the beneficiary's primary care provider...

For 2025, Wellcare will be offering plans to more than 51 million beneficiaries, which accounts for 77% of all eligible Medicare beneficiaries in our ___ states. Correct answers 32 Many of our Medicare Advantage (MA) plans offer supplemental benefits above and beyond what is offered on Original Medicare. Examples include: (Select all that apply) Correct answers Over-the-counter (OTC) items and medications Equestrian training In 2025, Medicare Advantage Prescription Drug (MAPD) plans wil...

Low-Income Subsidy (LIS), which is often referred to as Extra Help, reduces all Part D plan premiums. Correct answers False Which is an example of a top beneficiary complaint that affects Star Ratings? Correct answers 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. Correct answers Fa...

The Medicare Prescription Payment Plan allows prescription costs to be spread across _____ payments billed directly to the member. Correct answers Monthly Members who have LIS and enroll in a plan other than Wellcare's Classic plan will pay a premium regardless of LIS subsidy status. Correct answers True All Traditional Medicare Advantage Prescription Drug (MAPD) plans with drug coverage include a $0 copay Tier 6 at all in-network pharmacy locations. Correct answers True In 2025, Med...

20. Beneficiary-facing marketing materials developed by a Third-Party Marketing Organization (TPMO) for multiple Medicare Advantage (MA) organizations or plans can be reviewed by just one MA organization, submitted to the Centers for Medicare & Medicaid Services (CMS) in the Health Plan Management System (HPMS), and opted in by the health plan after distribution. Correct answers FALSE Enrollment applications must be received by Wellcare no later than ___ calendar day(s) following receipt from...

You can help prevent grievances by: (Select all that apply.) Correct answers 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 ...

True Correct answers Centene requires all contracted brokers/agents to read, understand, and agree to Centene's Business Ethics and Code of Conduct Policy. True False d. All of the above Correct answers 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 inv...

Effective 2025, key provisions of the Inflation Reduction Act include a lower annual threshold of $_____ for out-of-pocket (OOP) prescription drug costs in Medicare. Correct answers $2,000 Wellcare launched new tiered provider plans in ______ and _____. (Select two options.) Correct answers Arizona and Oregon For 2025, Wellcare has 43 new plans going to market. Correct answers True Best practices to keep in mind for Dual Eligible Special Needs Plan (D-SNP) and Chronic Condition Special ...

Wellcare launched new tiered provider plans in ______ and _____. (Select two options.) Correct answers Arizona, Oregon For 2025, Wellcare will be offering plans to more than 51 million beneficiaries, which accounts for 77% of all eligible Medicare beneficiaries in our ___ states Correct answers 32 Wellcare's _____ plan is designed for Low-Income Subsidy (LIS) members Correct answers Wellcare Classic Which Prescription Drug Plan (PDP) is best for a dual-eligible chooser? Correct answe...

Which Prescription Drug Plan (PDP) is best for a dual-eligible chooser? Correct answers Classic For 2025, Wellcare has 43 new plans going to market Correct answers TRUE Members are no longer required to pay a partial deductible due to the Inflation Reduction Act. Correct answers True Names and/or logos of provider co-branding partners can be displayed on marketing materials, as long as the current and approved logos are used. Correct answers False CustomPoint® sales material order d...

ANCC Georgette Review for boards exam with 100% correct solutions 2024 Georgette Review PMHNP. Exam with 100% correct solutions 2024

3 yr old play with self, says naughty things. Normal for which theorist Correct answers Piaget Which cranial nerve for 14yr old clenching teeth Correct answers Trigeminal, Cranial nerve V 16yr old falls with wrong crowd may have what disorder Correct answers Conduct disorder Ace inhibitors are drug choice for what Correct answers Heart failure, HTN Acute distress disorder must occur within what time frame Correct answers 1 month of trauma and resolve within the month Exposure to a...

A patient with borderline personality disorder experiences intense anxiety when an adult psychiatric and mental health nurse practitioner goes on vacation. The best explanation for this reaction is that the patient: A. has failed to develop clear ego boundaries. B. has failed to master object constancy. C. is employing primitive idealization. D. is employing projective identification. Correct answers B. has failed to master object constancy 2. A patient has been taking escitalopram (Lexap...