WELLCARE EXAM 2024 EXAM QUESTIONS AND ANSWERS 100% ACCURATE!
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Course
WELLCARE EXA
Institution
WELLCARE EXA
A request to the plan to the plan from a member or provider for a formal review of an Action (Denial) or
Adverse Plan Determination (medicare) is a/an: - ANSWER a.APPEAL
A grievance request, or any evidence concerning a grievance, must be filed orally or in writing no later than __ calendar da...
, WELLCARE EXAM 2024 EXAM
QUESTIONS AND ANSWERS 100%
ACCURATE!
A request to the plan to the plan from a member or provider for a formal review of an
Action (Denial) or
Adverse Plan Determination (medicare) is a/an: - ANSWER a.APPEAL
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. - ANSWER 60
An LEP is assessed by CMS when a member goes___days or longer without creditable
prescription drug
coverage after they become Medicare-eligible. - ANSWER B. 63 DAYS
Ascend is a fast, easy, and compliant way for brokers/agents to submit agent-assisted
electronic
enrollments. - ANSWER TRUE
A Health Risk Assessment (HRA): - ANSWER a. Provides physiscians with an overview
of a member's health status.
B. help us understand the
unique health situation og each of our members and allows us to make sure they
receive the
services that meet their needs.
c. is an important part of our quality initiative, directly
impacting our star ratings.
D. ALL OF THESE (CORRECT)
A broker/agent may be terminated for cause if they fail to comply with compliance
investigation, encourage others to avoid the compliance interview process, or fail to
provide truthful complete information. - ANSWER TRUE
A broker/ agent who has never had any verbal warnings cannot be issued a corrective
action plan. - ANSWER FALSE
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