uhc ethics and compliance section for certification questions and answers with complete solution rated a
what is a servicing agent
what does cms stand for
who administers the medicare program and
Written for
UHC
All documents for this subject (760)
Seller
Follow
AdvancedLevelExpert
Reviews received
Content preview
UHC Ethics And Compliance Section For
Certification
What is a servicing agent? - an inactive, nonemployee who has signed a servicing
agreement in order to receive renewal commisions on medicare advantage and
prescription drug plan enrollments on or after 1-1-2014. the agent must maintain an active
resident license and appointment and pass medicare basics and ethics compliance
assessments on an annual basis
What does CMS stand for? - center for medicare and medicaid services
Who administers the medicare program and contracts with private health care companies
to offer medicaid plans? - CMS
Who holds the authority to approve or disaprove plans that can be sold, and is the
regulating agency that also monitors our progresses? - CMS
Who regulates MA's and PDP's - CMS
Enrolling a customer in a plan when you are not certified in the product is non-compliant
and considered____? - an unqualified sale
Agents who are not qualified to sell the product will not be? - compensated and may
receive corrective and or disciplinary action up to an including termination
What is the purpose of an educational event? - its designed to inform medicare consumers
about original medicare, medicare advantage, prescription drug and other medicare
programs.
Where must educational events be conducted? - in a public venue
Are the educational events unbiased so that it doesn't steer the consumer towards a
specific plan or limited number of plans? - yes
WHat is a marketing/sales event? - an event designed to steer or attempt to steer,
consumers toward a plan or limited set of plans. Agents may discuss plan specific
information and collect applications.
Can marketing/sales be formal or informal? - both
What describes a formal marketing/sales event? - a full plan presentation, given in a
presenter-audience format.
, What is an inform marketing/sales event? - they're passive in nature where the consumer
approaches the agent to engage in conversation. a booth, table, or kiosk is typically used
What are marketing appointments? - They're commonly referred to as "in home, face to
face, or one on one appointment" and typically take place in the consumers home.
What other places can marketing appointments happen? - coffee shop, or even over the
phone
because marketing appointments are not formal and informal marketing sales events,
they're not reported to who? - UHC or CMS. instead, agents must obtain a completed scope
of appointment prior to conducting the appointment.
To report events, what should agents use? - an event request form
to ensure that events are in UHC's event reporting application no less than 7 calender days
prior to the event... - submit the event request form, according to instructions on the form,
NO LESS THAN 14 CALENDAR DAYS
event request forms submitted within7 calendar days will NOT be what? - processed
conducting an unreported event is _____? - prohibited
to schedule a sign language interpreter for a formal marketing/sales event or a
personal/individual marketing appointment, enter the consumer's request direct;y in
bconnected at least? - 14 days prior to the event or appointment
What are marketing materials used for? - 1) draw attention to a plan sponsor or their
plan(s) and
2) influence a consumer's decision when selecting a plan in which to enroll or a member's
decision to remain enrolled in their current plan
Marketing materials contain information about the plan or plans: - 1) benefits or benefit
structure
2) cost sharing ( including premiums, copayments, and deductibles)
3) Measurements or ranking standards ( such as star ratings. comparisons to other plans,
or statistical studies or surveys)
Approval is required for? - 1) ALL medicare marketing materials or
2) ANY material that mentions a plan sponsor ( such as " united health care") one of its
affliated plans or displays any logos
What does generic mean with marketing materials? - materials that do not meet the
marketing materials criteria and do not carry any plan sponsor information or logos
does generic materials require prior approval? - no
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller AdvancedLevelExpert. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $13.29. You're not tied to anything after your purchase.
