Exam (elaborations)
Wellcare(100%) Correct Solutions
- Module
- USMLE Step 1 Pharm
- Institution
- USMLE Step 1 Pharm
Wellcare(100%) Correct Solutions
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Wellcare(100%) Correct SolutionsNoting the correct enrollment period on enrollment applications helps in preventing
delayed enrollment processing.
Select one:
True
False - ANS-True
Which of the following actions are you required to do when contacted regarding an
allegation of noncompliant activity?
a. Speak with the investigator as quickly as possible.
b. Answer all questions honestly and completely.
c. Offer information and documents important to the investigation.
d. All of the above - ANS-All the above
By selecting the correct provider during the enrollment process, you can:
a. Increase member satisfaction.
b. Ensure timely access to the member's PCP.
c. Minimize call volumes/complaints.
d. All of the above - ANS-All the above
Centene requires all contracted agents to read, understand, and agree to Centene's
Business Ethics and Code of Conduct Policy.
Select one:
True
False - ANS-True
Which of the following is not an example of Protected Health Information (PHI)?
a. Medical records
b. Payment history
c. Library card - ANS-Library card
, Communication of PHI can be:
(Select all that apply.)
a. Written
b. Electronic
c. Verbal - ANS-Written, Electronic, Verbal
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?
a. Member Service
b. Reputation
c. Member Payments
d. Serving Government Customers - ANS-Member Payments
Verbal permission granted to discuss plan details qualifies an authorized representative
to complete an application on behalf of the beneficiary.
Select one:
True
False - ANS-False
Agents may be investigated after being suspected of noncompliant activity reported
through a:
(Select all that apply.)
a. Complaint Tracking Module (CTM)
b. Yelp Review
c. Grievance
d. Secret Shop Finding - ANS-Complaint Tracking Module (CTM), Grievance, Secret
Shop Finding
Failure to inform a beneficiary that a trusted provider is out-of-network or is not available
in the newly selected plan can cause a sales allegation.
Select one:
True
False - ANS-True
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