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
... [Show More] event or the date the member is made aware of the issue.
60
When completing an application, you should ensure that you enter the provider ID of a specialist and not a Primary Care Physician (PCP).
False
Which of the following statements about completing telephonic enrollments is FALSE?
Must include most of the required elements necessary to complete the enrollment
A passing score of __ or higher must be achieved to successfully complete this course
85%
To ensure accurate data entry, you should repeat the Medicare ID back to the beneficiary.
True
Steps to take when safeguarding and securing PHI and PII include
All of the Above
An 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
True
For 2022, ______ will no longer be a preferred pharmacy
Walmart
The Part D Senior Savings Model (SSM), which reduces member spending on insulin, will be offered on the Value Script and Value Plus products
True
Communication of PHI can be:
Written, Electronic, Verbal
Agents must meet all required contracting, training, and certification requirements to be eligible to sell Wellcare's Medicare Products
True
Wellcare offers a robust portfolio of products and plans across _____ states.
50
When enrolling a D-SNP beneficiary, be sure to verify plan enrollment eligibility and that the MSP program level is eligible for the requested plan.
True
Wellcare's 2022 product expansion represents an 8% increase from 2021.
True
Which stage of coverage is referred to as the "donut hole" as the member is paying the most for drug coverage:
Coverage Gap
Noting the correct enrollment period on enrollment applications helps in preventing delayed enrollment processing:
True
Which of the following actions are you required to do when contacted regarding an allegation of noncompliant activity?
All of the Above
Wellcare PDP is consolidating from six plan offerings to three plan offerings for 2022. Identify the INCORRECT statement regarding the plan consolidation.
The agent of record will not remain with the member after the consolidation.
All Wellcare standalone PDP plans will have a $0 Tier 1 preferred retail and mail benefit:
True
Any request or distribution of PHI should contain only the minimum amount of PHI required to complete the intended task.
True
Wellcare offers a wide variety of Medicare products consolidated under a new Wellcare brand
True
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?
Member Payments
Agents may be investigated after being suspected of noncompliant activity reported throughSelect all that apply.
Compliant tracking module, grievance, secret shop finding
Wellcare has streamlined standalone PDP offerings from six plans to ___ in all 34 regions across all 50 states and D.C.
Three plans
For the 2022 plan year, which health plans will be consolidated into the Wellcare Medicare brand:
Health Net, Fidelis Care, AllWell, 'Ohana, Trillium Advantage, WellCare [Show Less]