WellCare 2020 Questions and Answers

In the event you need to use a paper Scope of Appointment (SOA) form, it must be completed____ hosting the sales presentation. - ANSWER Prior to Agents can use the Materials Portal to order sales materials and track shipment - ANSWER True Agents may be terminated for cause if they fail to comply with a compliance investigation, encourage others to avoid the compliance interview process or fail to provide truthful or complete information - ANSWER True If a paper Scope of Appointment (SOA) form was used to capture SOA, and your appointment turns into an application for enrollment, which mandatory action is true? - ANSWER Fax it into WellCare along with the paper application. A call to the Application Verification Line (VAL) is required for whihc type of application - ANSWER Agent-Assisted Online Enrollment Application Tool Which of the following are agents permitted to do when using the Personal URL (PURL) - ANSWER None of these What is the application tracker in Agent Connect used for? - ANSWER Tracking submitted applications A scope of Appointment (SOA) is required if benefits are going to be discussed prior to a beneficiary enrolling on their own via your Personalized URL (PURL) - ANSWER True WellCare accepts Scopes of Appointment (SOA) in which of the following methods? - ANSWER Mobile App Telephonic (AVL) Paper Which of the following takes place when using the personalized application page while faxing paper applications? (Select all that apply) - ANSWER - The bar code is linked with your agent ID and certification status. - The personalized application page must be the final page of every fazed application submission. - An auto-generated email will be sent within five minutes of the completed fax transmission. - The bar code on the the page will be scanned as the application connects with WellCare systems. AHIP satisfies CMS requirements for which of the following? (select all that apply) - ANSWER Compliance Fraud Waste & Abuse Applications can be tracked from start to finish within your Agent Connect portal. - ANSWER True Inquiries are not grievances because they do not express dissatisfaction. - ANSWER True The Mobile Scope of Appointment (SOA) & Enrollment platform enables agents to capture/store SOA and complete/submit an enrollment application. - ANSWER True Which of the following are examples of potential disciplinary actions that could be issues against an agent? ( Select all that apply) - ANSWER Verbal coaching Monitoring action plan Termination not for cause Written warning One way for you, an agent, to help WellCare with maintaining a high Star Rating is to encourage your members to complete the HRA in a timely fashion - ANSWER True You may advertise using the WellCare name and/or logo without prior approval from WellCare - ANSWER False The Personalized URL (PURL) can be used to enroll beneficiaires into a WellCare plan when you are in the home - ANSWER False Which of the following is/are the benefits of the Appointment Verification Line (AVL) via a phone call with the beneficiary? (Select all that apply) - ANSWER AVL telephonically records SOA via a phone call with the beneficiary Records and saves the Scope of Appointment (SOA) per CMS regulations via a live agent speaking with the beneficiary Provides an Appointment ID to use for an agent-assisted online application An agent may use the Personalized URL (PURL) to compliantly submit an enrollment application on behalf of their beneficiary. - ANSWER False Per CMS guidelines, you can take a 2020 application beginning October 1, 2019 but the application cannot be submitted until October 15, 2019 - ANSWER False The True Out-of-Pocket (TrOOP) for 2020 will be: - ANSWER $6,350 For plan year 2020, Wellcare standalone Prescription Drug Plans (PDP) will offer the same 90-day Preferred Mail Order benefit as 2019: *Tier 1 copay of $0 *Tier 2 and Tier 3 copay of 2.5x the 30 day Preferred - ANSWER True For plan year 2020, WellCare has expanded and enhanced product offering across the country. - ANSWER True Prescription drugs can be obtained at a preferred cost-share at certain stores/chains. - ANSWER True If a current member has received the Annual Notice of Changes (ANOC) document and has a question about 2020 benefits in September, we are permitted to answer 2020 benefit questions. - ANSWER True Which Prescription Drug Plan (PDP) is best for dual-eligible members? - ANSWER The Classic Plan Generics and brand name drugs are covered on which Part D drug tier/s? - ANSWER All tiers Which of the following is a new WellCare Prescription Drug Plan (PDP) - ANSWER Wellness RX WellCare offers the following methods for agent-assisted enrollment applications: (select all that apply.) - ANSWER -eApp Mobile/Tablet - Paper application Fax Submission - eApp Desktop - Paper Application PDF Upload Grievances may be filed by which of the following methods? - ANSWER Phone Fax Written request to the WellCare Grievance Department You may include a member name and member ID in the subject line of an email if you are reporting a member concern to WellCare. - ANSWER False Which of the following materials should you leave with the beneficiary after completing an enrollment into a WellCare Health Plan? - ANSWER Select all of the above. Agents who wish to use the new Mobile Scope of Appointment (SOA) app to capture SOA are encouraged to complete the SM Mobile Scope of Appointment APP training in WellCare University. - ANSWER True The Minimum Necessary Rule within the Privacy Rule requires that any request or distribution of protected health information (PHI) occurs with only the minimum amount of PHI required to complete the intended task. This includes email and physical distribution. - ANSWER True What is the application tracker in Agent Connect used for? - ANSWER Tracking submitted applications You may advertise using the WellCare name and/or logo without prior approval from WellCare - ANSWER False A complaint or vialation that could not be substaintied and where no pattern of compliance issues exists is a founded complaint. - ANSWER False Applications can be tracked from start to finish within your Agent Connect protal. - ANSWER True The Health Risk Assessment (HRA) is an important part of our quality initiative as it: - ANSWER -Gives WellCare the ability to prevent any further health challenges -Impacts Star Ratings -Helps ensure WellCare members are able to access care A member or member's representative must submit a grievance request or evidence concerning a grievance 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 Agents can use the Materials Portal to order sales materials and track shipment. - ANSWER True If you suspect inappropriate conduct within WellCare, you should report it to: - ANSWER District Sales Managers Regional Compliance or Regulatory Staff