Pbm dual Study guides, Class notes & Summaries

PBM DUAL CREDIT FINAL EXAM REVIEW PART 2 EXAM 2024...

PBM DUAL CREDIT FINAL REVIEW PART 1 EXAM ...

With the Pharmacy Benefit Manager (PBM) migration to Express Scripts effective 1/1/2024, existing members can continue to use their current ID card 1/1/2024 and beyond. - Answer-False - With the PBM migration to Express Scripts effective 1/1/2024, all existing members will receive a new ID card containing new pharmacy processing information and must use their new ID card starting 1/1/2024. Wellcare's _____ plan is designed for Low-Income Subsidy members. Question 29Select one:a. Classic b...

Wellcare Exam (2024) || Complete Questions and Solutions (Rated A+) Wellcare Exam (2024) || Complete Questions and Solutions (Rated A+) Business Required Document (BRD) - ANSWER - written by business analyst (BA); created when new CMS regs come out, DTRR comes to us daily, read and apply Functional Specific Document (FSD) - ANSWER - detailed doc w/tables, names of files. etc. Accumulation Files - ANSWER - DSNP are excluded, MOOP accums sent daily to PBM, 9M layout format; outbound is a...

Business Required Document (BRD) - ANSWER-written by business analyst (BA); created when new CMS regs come out, DTRR comes to us daily, read and apply Functional Specific Document (FSD) - ANSWER-detailed doc w/tables, names of files. etc. Accumulation Files - ANSWER-DSNP are excluded, MOOP accums sent daily to PBM, 9M layout format; outbound is all medical; "sending medical dollars in a format Dual Eligibility - ANSWER-entitled to Medicare (always primary payor) and Medicaid HEDIS -...

Which is an example of a top beneficiary complaint that affects Star Ratings? The beneficiary did not understand that enrolling in a Wellcare plan would change their current Medicare Advantage plan An SEP is a period outside of the ICEP, AEP, or MA OEP when beneficiaries can enroll based solely on life events that qualify for an SEP period. True Brainpower Read More 0:00 / 0:00 Prior to the beginning of the enrollment process, a broker/agent is required to cover certain be...

Which is an example of a top beneficiary complaint that affects Star Ratings? The beneficiary did not understand that enrolling in a Wellcare plan would change their current Medicare Advantage plan An SEP is a period outside of the ICEP, AEP, or MA OEP when beneficiaries can enroll based solely on life events that qualify for an SEP period. True Prior to the beginning of the enrollment process, a broker/agent is required to cover certain beneficiary specific information, includin...

Wellcare 2024 Questions and Answers Already Passed Which is an example of a top beneficiary complaint that affects Star Ratings? The beneficiary did not understand that enrolling in a Wellcare plan would change their current Medicare Advantage plan An SEP is a period outside of the ICEP, AEP, or MA OEP when beneficiaries can enroll based solely on life events that qualify for an SEP period. True Prior to the beginning of the enrollment process, a broker/agent is required to cover certain benef...

Low-Income Subsidy (LIS), which is often referred to as Extra Help, reduces all Part D plan premiums. False Which is an example of a top beneficiary complaint that affects Star Ratings? The beneficiary did not understand that enrolling in a Wellcare plan would change their current Medicare Advantage plan. Brainpower Read More Previous Play Next Rewind 10 seconds Move forward 10 seconds Unmute 0:00 / 0:00 Full screen Providers may create co-branded marketing pieces u...

Which is an example of a top beneficiary complaint that affects Star Ratings? - ANSWER-The beneficiary did not understand that enrolling in a Wellcare plan would change their current Medicare Advantage plan An SEP is a period outside of the ICEP, AEP, or MA OEP when beneficiaries can enroll based solely on life events that qualify for an SEP period. - ANSWER-True Prior to the beginning of the enrollment process, a broker/agent is required to cover certain beneficiary specific information, ...