2023 UHC United HealthCare - Ethics and Compliance Test Bundle

In terms of events, which of the following is true? - WRONG - Agents must report formal marketing/sales events only to UnitedHealthcare When completing an enrollment application in LEAN, why is an agent prohibited from entering their own email address in a field available for the consumer's e...

What is a servicing agent? - an inactive, nonemployee who has signed a servicing agreement in order to receive renewal commisions on medicare advantage and prescription drug plan enrollments on or after 1-1-2014. the agent must maintain an active resident license and appointment and pass medicare...

Gene got Medicare before he turned 65 and enrolled into a Medicare Advantage plan. He calls in February the month before his 65th birthday and is unhappy with his current plan. On the date of the call, what can Gene do about his coverage? - On the day he called, he can enroll in a different Medic...

What type of events must an agent report to UnitedHealthcare? - Only the marketing/sales events, both formal and informal. While using LEAN to complete an enrollment application with a consumer, Agent Jeff learns the consumer does not have an email address. What should Jeff do? - Leave any ...

Gene got Medicare before he turned 65 and enrolled into a Medicare Advantage plan. He calls in February the month before his 65th birthday and is unhappy with his current plan. On the date of the call, what can Gene do about his coverage? - On the day he called, he can enroll in a different Medic...

reporting all events (marketing/sales and educational) to united health care is required so that the company can: - Comply with CMS and medicaid services event reporting You have a scheduled appointment with a consumer to discuss DSNP. They have the SOA form. 2 days before the appointment they...

What is the CMS-adopted NFPA standard for portable fire extinguishers? - NFPA 10 2010 Edition What is the CMS-adopted NFPA National Electric Code? - NFPA 70 2011 Edition What is the CMS-adopted NFPA standard for a health care facilities code? - NFPA 99 2012 Edition What is...

Medicare - Federal health insurance program Medicare is administered by whom? - CMS ( Centers for medicare and medicaid services) Parts A & B of medicare are - federal health insurance program referred to as original medicare Part A? - Hospital insurance Part B? - Medical ...

What are the external and internal parts of health care compliance? - External: Federal and state statutes and regulations (e.g. HIPPA, FTC) Internal: Organizational policies and procedures (e.g. private practice has their own policies and you must follow) What does the PPACA Section 6401 say...

Lisa turned 65 and is now eligible for Medicare. She already receives Social Security benefits. How does she enroll in Original Medicare? - Her enrollment in Medicare Parts A and B is generally automatic if she meets all eligibility requirements. Which statement is true about a member of a Med...

When completing an enrollment application in LEAN, why is an agent prohibited from entering his or her own email address in a field available for the consumer's email address? - The consumer/member would not receive plan related correspondence intended for him/her By agreeing to the Statement...

What type of event must agent conduct when she wants to be able to collect consumer information schedule future appointments and accept enrollment applications marketing/sales event Louise wants to hold an event that helps consumers understand Medicare programs and perhaps an prove their healt...

5 most important federal fraud and abuse laws: - *False Claims Act (FCA) *Anti - kickback Statute (AKS) *Physician Self-Referral Law (Stark I II III ) *Exclusion Authorities *Civil Monetary Penalties Law (CMPL) The purpose of EMTALA is to prevent: a. Hospitals from rejecting patients in a...

OBB - Operation Bad Bundle- Labs, DME, hospice, home health GAO - General Accounting Office- identified high risk of F/A in Medi What was the first major auditing target? - Teaching hospital CPUP - Clinical Practices of the University of Pennsylvania What was identified by ...