Wellcare Mastery Exam with Questions and Correct Answers Verified Solutions
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Course
Wellcare Mastery
Institution
Wellcare Mastery
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:
Appeal
Grievance procedures are separate and distinct from initial determination and appeal
procedures.
TRUE
A grievance request, or any evidence concern...
Wellcare Mastery Exam with Questions and
Correct Answers\ Verified Solutions
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:
Appeal
Grievance procedures are separate and distinct from initial determination and appeal
procedures.
TRUE
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 event or the date the
member is made aware of the issue.
60
Once the enrollment is completed, you can save a copy of the application for your
reference.
FALSE
Member PHI can be stored on an external hard drive or a cloud storage service like
Google Drive or Apple Cloud.
FALSE
Which will be Wellcare's Preferred Mail Order pharmacy?
Express Scripts® Pharmacy
The Medicare Prescription Payment Plan is a payment option that helps manage out-
of-pocket (OOP) Part B costs by allowing members who opt-in to spread costs
throughout the benefit year.
FALSE
All three Prescription Drug Plans (PDPs) will offer a five-tier formulary design.
TRUE
The _________ plan is expected to continue to offer members a cost-effective option,
with one of the lowest premiums in the nation!
, Value Script
Wellcare Mutual of Omaha co-branded plans are offered in _____ states.
Five
Wellcare offers Medicare Advantage (MA) products to meet the needs of a variety of
beneficiaries. We offer:
All of these
All Traditional Medicare Advantage Prescription Drug (MAPD) plans with drug
coverage include a $0 copay Tier 6 at all in-network pharmacy locations.
TRUE
Only members with a standalone Prescription Drug Plan (PDP) are eligible to use the
Medicare Prescription Payment Plan option.
FALSE
As part of Centene's Ethics and Compliance program, Centene requires all agents to
review and agree to its Business Ethics and Code of Conduct Policy.
TRUE
Disciplinary actions stemming from the result of a compliance allegation are always
progressive.
FALSE
Self-reporting of a compliance issue must be made to Corporate Compliance or to a
Health Plan Sales Leader and must indicate:
All of these
A Scope of Appointment (SOA) is valid _____ following the beneficiary's signature
date.
12 months
Members have several options to pay plan premiums. The best option to ensure
regular and timely payments are:
All of these
Names and/or logos of provider co-branding partners can be displayed on marketing
materials, as long as the current and approved logos are used.
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