023 Centene Cert Review Questions with Complete
Solutions
Wellcare offers a range of Medicare plans to provide members with affordable access
to: -Answer- All of the above
Which of the following statements about comp
...
023 Centene Cert Review Questions with Complete
Solutions
Wellcare offers a range of Medicare plans to provide members with affordable access
to: -Answer- All of the above
Which of the following statements about completing telephonic enrollments is FALSE? -
Answer- Must include most of the required elements necessary to complete the
enrollment.
Communication of PHI can be:
(Select all that apply.) -Answer- a.
Written
b.
Electronic
c.
Verbal
Verbal permission granted to discuss plan details qualifies an authorized representative
to complete an application on behalf of the beneficiary. -Answer- FALSE
You can help prevent grievances by:
(Select all that apply.) -Answer- a.
Always confirming availability of the beneficiary's primary and specialist providers by
using the provider search tool available on the plan's website.
b.
Always using plan materials to clearly explain plan benefits and cost (including
medications) and check for understanding.
c.
Always confirming a beneficiary's intent to enroll before accepting their enrollment
application.
What are some examples of steps that can be taken when safeguarding and securing
PHI and PII?
(Select all that apply.) -Answer- a.
Shred documents that contain PHI or PII using appropriate means.
b.
Never leave laptops, PHI, or PII in an unattended vehicle.
c.
Do not include PHI or PII in the subject line or body of an email.
d.
Secure emails that contain PHI or PII.
Centene requires all contracted agents to read, understand, and agree to Centene's
Business Ethics and Code of Conduct Policy. -Answer- TRUEOnce the enrollment is completed, you can save a copy of the application for your
reference. -Answer- FALSE
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
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. -Answer- TRUE
An agent who has never had any verbal warnings cannot be issued a Corrective Action
Plan. -Answer- FALSE
Key areas you as an agent have control over and impact upon regarding Star Ratings
for quality are: -Answer- All of the above
The information contained within ACT will equip agents to certify, market, and sell which
health plans? -Answer- All of the above
Which of the following is not an example of Protected Health Information (PHI)? -
Answer- Library Card
Any request or distribution of PHI should contain only the minimum amount of PHI
required to complete the intended task. -Answer- True
When completing an application, you should ensure that you enter the provider ID of a
specialist and not a primary care physician (PCP). -Answer- False
Upon completion of the application, you must provide the beneficiary with the enrollment
application confirmation ID. -Answer- True
Member PHI can be stored on an external hard drive or a cloud storage service like
Google Drive or Apple Cloud. -Answer- False
All PDPs will continue to offer $0 tier 1 preferred cost-sharing through CVS Medication
Home Delivery (Mail Order). -Answer- True
Value Script and Value Plus PDP products have a ___-tier formulary structure for 2023.
-Answer- 6
For 2023, Ascension Complete added 27 new counties to their footprint. -Answer- True
Centene continues to expand its reach by offering more products in a wider geography.
____ new Wellcare and Ascension Complete plans are g
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