Centene ACT ME Review Questions and Answers with Complete Solutions
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Course
Centene ACT ME
Institution
Centene ACT ME
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. True
Which of the following health plans are now available through Centene Corporation? Select the
best answ...
Centene ACT ME Review Questions and Answers with Complete Solutions 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. ✔✔True Which of the following health plans are now available through Centene Corporation? Select the best answer. ✔✔Health Net, Fidelis Care, Allwell, Ascension Complete, WellCare True or Fals e: The four stages of coverage are NOT the same for PDP and MAPD. ✔✔False True or False: PII stands for Personally Identifiable Information and includes any information that permits the identity of an individual to be inferred, including information linke d or linkable to the individual. ✔✔True True or False: When enrolling a beneficiary, you should ensure that you enter the provider ID of a specialist and not a primary care physician (PCP). ✔✔False True or False: 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. ✔✔True True or False: A complaint or violation that could not be proven and where no pat tern of compliance issues exists is a founded complaint. ✔✔False 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 dur ing the seven -month period that: ✔✔All the above True or False: Centene will offer 6 Part D standalone plans in all 34 regions across all 50 states; 204 plans nationwide. ✔✔True True or False: For plan year 2021, our PPO offerings have doubled ✔✔True Which of the following is not an ancillary benefit on Centene's Medicare Advantage plans? ✔✔Personal shopping services True or False: The Minimum Necessary Rule within the Privacy Rule requires that any request or distribution of PHI includes only the min imum amount of PHI required to complete the intended task. This includes email and physical distribution. ✔✔True OEP runs from January 1 to March 31. Which of the following statements apply: ✔✔All the above The NEW Part D Senior Savings Model (SSM) _____ member spending on insulin. ✔✔Reduces True or False: Upon completion of the application, you must provide the beneficiary with the enrollment application confirmation ID. ✔✔True Generics and brand name drugs are covered on which Part D drug tiers? ✔✔All of the above True or False: The Centene and WellCare integration offers a wide variety of products/ plan offerings to your client. ✔✔True True or False: Per CMS, all telephonic enrollment must be completed on a recorded call. ✔✔True True or False: If t he application is being completed by an authorized representative, all corresponding fields must be completed. ✔✔True
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