Humana 2022 (Compliance Knowledge Check for Certifying Agents)
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Course
Humana
Institution
KAPLAN UNIVERSITY
An agent has an agreement with a provider's office that states for every member the agent enrolls in a Medicare plan and chooses the provider as the primary PCP, the agent will receive 20 dollars. Is this acceptable?
No, this situation constitutes a conflict of interest (COI) because the agent wil...
humana 2022 compliance knowledge check for certifying agents
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KAPLAN UNIVERSITY
Humana
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Humana 2022 (Compliance Knowledge
Check for Certifying Agents)
An agent has an agreement with a provider's office that states for every member the agent enrolls
in a Medicare plan and chooses the provider as the primary PCP, the agent will receive 20
dollars. Is this acceptable? Correct Answer: No, this situation constitutes a conflict of interest
(COI) because the agent will have a personal financial interest when members choose the PCP.
What is the definition of a critical Section A violation? Correct Answer: Typically a willful
action reported to Humana by the Medicare beneficiary
Penalties and sanctions for HIPAA privacy violations potentially include: Correct Answer: Fines
and possible imprisonment
Agent Deane works alongside several other agents while she conducts calls. Her headset can
make her ear sore by the afternoon, so she likes to put clients on speaker phone. Is this
acceptable? Correct Answer: No. Agent Deane should avoid putting her customers on speaker
phone in an open environment as personal health and financial protected information might be
shared and overheard by others.
During a presentation, a beneficiary clearly does not understand the plan concept. The Humana
sales Agent should: Correct Answer: Stop the presentation and ask if a spouse/family member/
caregiver is available. You may be able to question if the beneficiary is competent and determine
if they can make their own healthcare decisions.
Taking reasonable efforts to limit access of protected information to only those individuals who
have a need to know the information to perform a job duty' best describes the concept of: Correct
Answer: Minimum Necessary
Corrective action for committing a violation may include which of the following: Correct
Answer: Additional Training
Agent Richrath is meeting a fellow agent for lunch in a very nice part of town. Her messenger
bag containing her laptop she uses for work is in the backseat. What should she do to safeguard
her work computer, which may contain customer`s personal information? Correct Answer: She
should place the bag and all protected information in the trunk of her car or conceal the bag if
she does not have a trunk
Agent Jackson received the names and phone numbers of several people who are members of a
bowling league for seniors. She is pretty sure they would appreciate learning about all of
Humana's great Medicare plans, so she decides to text them and ask that, if interested, they call
her to learn more. Is this acceptable? Correct Answer: No, use of telephonic solicitation,
including text messages and leaving electronic voicemail messages is prohibited.
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