2024 wellcare mastery test Study Guide Rated A+
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
Any request or distribution of PHI should contain only the minimum amount of PHI required to complete the...
1). 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
Ans: answer: True
2). Any request or distribution of phi should contain only the minimum amount of phi required
to complete the intended task.
Ans: Answer: TRUE
3). 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:
Ans: Answer: Appeal
4). An agent who has never had any verbal warnings cannot be issued a corrective action plan
Ans: Answer: False
5). Which of the following actions are you required to do when contacted regarding an
allegation of noncompliant activity?
Ans: Answer: All of these
6). Which of the following statements about completing telephonic enrollments is false?
Ans: c.
Must include most of the required elements necessary to complete the enrollment.
7). Centene requires all contracted agents to read, understand, and agree to centene's business
ethics and code of conduct policy.
Ans: True
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, 8). At the end of this course, there will be a mastery exam. agents must achieve a passing
score of 85% or higher to successfully complete this course.
Ans: True
9). 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?
Ans: c.
Member Payments
10). 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.
Ans: True
11). Member phi can be stored on an external hard drive or a cloud storage service like google
drive or apple cloud.
Ans: False
12). You can help prevent grievances by:
Ans: Answer: A,B and C
13). Low-income subsidy (lis), which is often referred to as extra help, reduces all part d plan
premiums.
Ans: false
14). Which of the following is not considered a grievance?
Ans: c.
A dispute of the appeal of an organization determination, coverage determination, or a
Late Enrollment Penalty (LEP) determination.
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