NACC REVIEW COMPREHENSIVE
STUDY GUIDE 2026 FULL QUESTIONS
AND SOLUTIONS GRADED A+
◍ Which of the following are true about HIPAA? (Pick 3)Complaints about
breaches must be tracked and investigated All PHI should be kept
confidential Piggy-Backing is not a HIPAA violationAccess to PHI is based
on a "need to know" basis.
Answer: Piggy-Backing is not a HIPAA violation
◍ What are some examples of steps that can be taken when safeguarding and
securing PHI and PII?(Select all that apply.).
Answer: Shred documents that contain PHI or PII using appropriate
means.Never leave laptops, PHI, or PII in an unattended vehicle.Do not
include PHI or PII in the subject line or body of an email.Secure emails that
contain PHI or PII.
◍ Which option is the preferred method to submit enrollment?.
Answer: Ascend Web/Mobile Application
◍ Brokers/Agents can submit a support ticket online through their Centene
Workbench portal..
Answer: True
◍ What is the name of the annual member survey that is sent out to our MA
member which affect our STAR rating?SOBANOCCAHPSEOC.
Answer: CAHPS
◍ How do you document prospective member and CMS test calls in
Omni?Other action > Exit interaction Other action > Member not found >
Benefits & Eligibility inquiry Other action > Member not found > Log view
statusNo note is needed.
, Answer: Other action > Member not found > Log view status
◍ The Jade Plan is a CSNP plan for eligible members that have the following
chronic conditions: (pick 3)Back PainSinusitisDiabetes
MellitesCardiovascular disordersChronic Heart Failure.
Answer: Diabetes MellitesCardiovascular disordersChronic Heart Failure
◍ When discussing prescription drug coverage, you should:.
Answer: Explain how to use the formulary to look up limitations and
exclusions (e.g., step therapy, quantity limits).Confirm coverage of the
beneficiary's current and/or anticipated prescriptions.Explain formulary tiers
as well as drug copayment amounts.For drugs that are not covered by the
new plan, explain the Transition Fill program and how to request a coverage
exception.
◍ If a member disenrolls and chooses to go back to Original Medicare, they
will automatically have prescription drug coverage. TrueFalse.
Answer: False
◍ If a requested effective date is available for the special election period being
selected, ensure you are requesting a date within the correct time frame for
the member based on their eligibility date or change date needed..
Answer: True
◍ Which intent in Omni shows any preventive services a member needs to
complete?Accumulator inquiryBenefits & eligibilityGaps in careCare
Management.
Answer: Gaps in care
◍ Which Prescription Drug Plan (PDP) product has the richest formulary with
the most adherence generics on Tier 1?.
Answer: Value Plus
◍ Wellcare's 2024 product expansion represents a __% increase from 2023..
Answer: One
◍ A member can complete a form to grant another person permission to call
STUDY GUIDE 2026 FULL QUESTIONS
AND SOLUTIONS GRADED A+
◍ Which of the following are true about HIPAA? (Pick 3)Complaints about
breaches must be tracked and investigated All PHI should be kept
confidential Piggy-Backing is not a HIPAA violationAccess to PHI is based
on a "need to know" basis.
Answer: Piggy-Backing is not a HIPAA violation
◍ What are some examples of steps that can be taken when safeguarding and
securing PHI and PII?(Select all that apply.).
Answer: Shred documents that contain PHI or PII using appropriate
means.Never leave laptops, PHI, or PII in an unattended vehicle.Do not
include PHI or PII in the subject line or body of an email.Secure emails that
contain PHI or PII.
◍ Which option is the preferred method to submit enrollment?.
Answer: Ascend Web/Mobile Application
◍ Brokers/Agents can submit a support ticket online through their Centene
Workbench portal..
Answer: True
◍ What is the name of the annual member survey that is sent out to our MA
member which affect our STAR rating?SOBANOCCAHPSEOC.
Answer: CAHPS
◍ How do you document prospective member and CMS test calls in
Omni?Other action > Exit interaction Other action > Member not found >
Benefits & Eligibility inquiry Other action > Member not found > Log view
statusNo note is needed.
, Answer: Other action > Member not found > Log view status
◍ The Jade Plan is a CSNP plan for eligible members that have the following
chronic conditions: (pick 3)Back PainSinusitisDiabetes
MellitesCardiovascular disordersChronic Heart Failure.
Answer: Diabetes MellitesCardiovascular disordersChronic Heart Failure
◍ When discussing prescription drug coverage, you should:.
Answer: Explain how to use the formulary to look up limitations and
exclusions (e.g., step therapy, quantity limits).Confirm coverage of the
beneficiary's current and/or anticipated prescriptions.Explain formulary tiers
as well as drug copayment amounts.For drugs that are not covered by the
new plan, explain the Transition Fill program and how to request a coverage
exception.
◍ If a member disenrolls and chooses to go back to Original Medicare, they
will automatically have prescription drug coverage. TrueFalse.
Answer: False
◍ If a requested effective date is available for the special election period being
selected, ensure you are requesting a date within the correct time frame for
the member based on their eligibility date or change date needed..
Answer: True
◍ Which intent in Omni shows any preventive services a member needs to
complete?Accumulator inquiryBenefits & eligibilityGaps in careCare
Management.
Answer: Gaps in care
◍ Which Prescription Drug Plan (PDP) product has the richest formulary with
the most adherence generics on Tier 1?.
Answer: Value Plus
◍ Wellcare's 2024 product expansion represents a __% increase from 2023..
Answer: One
◍ A member can complete a form to grant another person permission to call
