Wellcare grievance request 2021 年 10 月 18 日2021 年 5 月 29 日 作者 Queenie 11,391 Views False Agents who have never had any verbal warnings cannot be issued a corrective action plan 60 A grievance request, or any evidence concerning a grievance, must be filed orally or in writing no later than 60 calendar days from the date of the event of the date the member is made aware of the issue. all of the above Steps to take when safeguarding and securing PHI and PII include: 327 Wellcare has added ____ new counties to our footprint in 2022 Library Card Which of the following is not an example of Protected Health Information (PHI) five All standalone PDP formularies have a ____ -tier structure for 2022 True To ensure accurate data entry, you should repeat the Medicare ID back to the beneficiary. Written, Electronic, Verbal Communication of PHI can be: All of the above (Member satisfaction/Experience, Complaints, Rapid Disenrollment) Key areas you as a Sales Agent/Broker have control over and impact upon regarding Star (quality) ratings are: True All Wellcare standalone PDP plans will have a $0 Tier 1 preferred retail and mail benefit. True Wellcare has expanded coverage in Massachusetts, Nebraska, and Oklahoma. True Wellcare offers a wide variety of Medicare products consolidated under a new Wellcare brand. True Any request of distribution of PHI should contain only the minimum amount of PHI required to complete the intended task. False When completing an application, you should ensure that you enter the provider ID of a specialist and not a Primary Care Physician (PCP). Must include most of the required elements necessary to complete the enrollment. Which of the following statements about completing telephonic enrollments is FALSE? Three Wellcare has streamlined standalone PDP offerings from six plans to __ in all 34 regions across all 50 states and D.C. All of the above (Ascension Complete and Wellcare) The information contained within ACT will equip agents to certify, market and sell which health plans? True Upon completion of the application, you must provide the beneficiary with the enrollment application confirmation ID. True Noting the correct enrollment period on enrollment applications helps in preventing delayed enrollment processing. True Wellcare’s 2022 product expansion represents an 8% increase from 2021 True Members in all plans impacted by the 2022 PDP contract consolidation will be reissued an ID card. All of the above Agents are to put into practice all guidelines set forth in: The Agent of Record (AOR) will not remain with the member after the consolidation Wellcare PDP is consolidating from six plan offerings to three plan offerings for 2022. Identify the INCORRECT statement regarding the plan consolidation. False Verbal permission granted to discuss plan details qualifies an authorized representative to complete an application on behalf of the beneficiary. Member Payments Medicare Star Ratings and performance are at the forefront of Wellcare’s quality strategy. Wellcare’s quality focus consists of six drivers. Which of the following is not a Wellcare quality driver? Complaint Tracking Module (CTM);Grievance;Secret Shop Finding Agents may be investigated after being suspected of noncompliant activity reported through a: Walmart For 2022, ____ will no longer be a preferred pharmacy. all 50 Wellcare offers a robust portfolio of products and plans across ____ states True The Part D Senior Savings Model (SSM), which reduces member spending on insulin, will be offered on the Value Script and Value Plus products. Health Net; Fidelis Care; Allwell; ‘Ohana; Trillium Advantage; Wellcare For the 2022 plan year, which health plans will be considered into the Wellcare Medicare brand? Coverage Gap (Stage 3) Which stage of coverage is referred to as the “donut hole” as the member is paying the most for drug coverage? A dispute of the appeal of an organization determination, coverage determination or a Late Enrollment Penalty (LEP) determination. Which of the following is not considered a grievance? True Agents must meet all required contracting, training, and certification requirements to be eligible to sell Wellcare’s Medicare Products. All of the above Which of the following actions are you required to do when contacted regarding an allegation of noncompliant activity? True When enrolling a D-SNP beneficiary, be sure to verify plan enrollment eligibility and that the MSP program level is eligible for the requested plan. a. Value Script b. Value Plus (not this one) c. Classic Which standalone Prescription Drug Plan is best for “dual-eligible” members? Related posts: UHC – HMO POS plans only cover in network services UHC – Permission to Contact When selecting a venue for your educational or marketing/sales event UHC Health Assessment AHIP Test 2 善終照護(Hospice)。善終照護關注🧓的是嚴重疾病者的護理、舒適和生活品質。
