In 2021, Centene is offering which of the the following types of Medicare
Advantage Prescription Drug (MAPD) products?
A. HMO and HMO/POS
B. DSNP and CSNP
C. PPO
D. PFFS Ans - E. All of the above
Beneficiaries who are first eligible for Medicare have a seven-month Initial
Enrollment Period...
2021 Centene ACT Mastery Exam / Mastery Exam 3
Study Guide 2021 / ACT Practice Exam - 2021 WPH
In 2021, Centene is offering which of the the following types of Medicare
Advantage Prescription Drug (MAPD) products?
A. HMO and HMO/POS
B. DSNP and CSNP
C. PPO
D. PFFS Ans - E. All of the above
Beneficiaries who are first eligible for Medicare have a seven-month Initial
Enrollment Period to enroll in a Medicare Advantage Plan. If eligible for
Medicare, beneficiaries can sign up during the seven-month period that:
A. Begins three months before the month in which the member turns 65.
B. Includes the month in which the member turns 65.
C. Ends three months after the month in which the member turns 65. Ans
- D. All the above
Per CMS, all telephonic enrollment must be completed on a recorded call.
Ans - T
Upon completion of the application, you must provide the beneficiary with
the enrollment application confirmation ID. Ans - T
Agents may be investigated after being suspected of noncompliant activity
reported through a Complaint Tracking Module (CTM), grievance, secret shop
finding, internal audit or reporting. Ans - T
If the application is being completed by an authorized representative, all
corresponding fields must be completed. Ans - T
A score of 85% or higher is needed to pass the 2021 ACT Mastery Exam.
Ans - T
When should you verify a beneficiary's eligibility for D-SNP? Ans -
Before the enrollment
The Centene product expansion has increased 5% from 2020. Ans - T
Generics and brand name drugs are covered on which Part D drug tiers?
A. Tiers 1 and 2
B. Tiers 3 and 4
, C. Tier 5 Ans - D. All of the above
OEP runs from January 1 to March 31. Which of the following statements
apply:
A. Beneficiaries can switch to another MA or MAPD Plan (including adding or
removing drug coverage).
B. Beneficiaries can disenroll from an MA or MAPD Plan and join Original
Medicare with or without a stand-alone Part D Plan.
C. Beneficiaries enrolled in Original Medicare cannot join an MA or MAPD
plan. Ans - D. All the above
To ensure accurate data entry, you should repeat the Medicare ID back to the
beneficiary. Ans - T
Which of the following are plans offered by Centene for beneficiaries that
have special needs? Ans - Both DSNP and CSNP
Which of the following are examples of potential disciplinary actions that
could be issued against an agent?
A) Verbal coaching
B) Corrective Action Plan
C) Written warning
D) Termination not for cause Ans - All of the above
An agent could 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. Ans
- T
Which of the following is not an ancillary benefit on Centene's Medicare
Advantage plans? Ans - Personal shopping services
When enrolling a beneficiary, you should ensure that you enter the provider
ID of a specialist and not a primary care physician (PCP). Ans - F
Centene currently serves over 23 million Managed Care members. Ans -
T
The Minimum Necessary Rule within the Privacy Rule requires that any
request or distribution of PHI includes only the minimum amount of PHI
required to complete the intended task. This includes email and physical
distribution. Ans - T
New for 2021- Walgreens added to preferred network, along with CVS and
most grocers, for 5 of 6 plans. Ans - T
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