2023 Wellcare ACT Mastery Certification Answered
By selecting the correct provider during the enrollment process, you can:- ANSWER All of the above
A grievance request, or any evidence concerning a grievance, must be fi led 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
The Single Sign-On Portal provides access to several applications, including Centene Workbench.
ANSWER True
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
Brokers/Agents may be investigated after being suspected of noncompliant activity reported through a
ANSWER -Complaint Tracking Module (CTM)
Grievance
-Secret Shop Finding
The NEW online Centene Workbench self-service portal enables you to: - ANSWER All of the above
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.
Once the enrollment is completed, you can save a copy of the application for your reference:- ANSWER
False
A Health Risk Assessment (HRA) can be completed for C-SNP and D-SNP plans only, before the
enrollment application process in Ascend through the Value Based Enrollment (VBE) portal. ANSWER
False
Which resources are available for download from the Shared Resources section found within Centene
Workbenchi? ANSWER All of the above
During an appointment, you may not discuss any products not agreed to in advance by the beneficiary.
a. True
b. False - Answer True
When a paper SOA form is used, it must be completed __________ hosting the sales presentation.
, a. Prior to
b. During
c. After - Answer A. Prior to
Brokers/Agents can submit a support ticket online through their Centene Workbench portal.
Select one:
True
False - Answer True
Wellcare does not need to be informed of all marketing/sales events at which plans or materials will be
presented or distributed (Formal & Informal).
Select one:
True
False - Answer False
Which of the following actions are you required to do when contacted regarding an allegation of
noncompliant activity?
a. Speak with the investigator as quickly as possible.
b. Answer all questions honestly and completely.
c. Offer information and documents important to the investigation.
d. All of the above - Answer D. All of the above
Key areas you as a broker/agent have control over and impact upon regarding Star Ratings for quality
are:
a. Member Satisfaction/Experience
b. Complaints
c. Rapid Disenrollment
d. All of the above - Answer D. All of the above
Noting the correct enrollment period on enrollment applications helps in preventing delayed enrollment
processing.
Select one:
True
False - Answer True
Health plan fax numbers vary for health plans that offer fax enrollment submissions.
Select one:
True
False - Answer True
Centene requires all contracted brokers/agents to read, understand, and agree to Centene's Business
Ethics and Code of Conduct Policy.
By selecting the correct provider during the enrollment process, you can:- ANSWER All of the above
A grievance request, or any evidence concerning a grievance, must be fi led 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
The Single Sign-On Portal provides access to several applications, including Centene Workbench.
ANSWER True
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
Brokers/Agents may be investigated after being suspected of noncompliant activity reported through a
ANSWER -Complaint Tracking Module (CTM)
Grievance
-Secret Shop Finding
The NEW online Centene Workbench self-service portal enables you to: - ANSWER All of the above
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.
Once the enrollment is completed, you can save a copy of the application for your reference:- ANSWER
False
A Health Risk Assessment (HRA) can be completed for C-SNP and D-SNP plans only, before the
enrollment application process in Ascend through the Value Based Enrollment (VBE) portal. ANSWER
False
Which resources are available for download from the Shared Resources section found within Centene
Workbenchi? ANSWER All of the above
During an appointment, you may not discuss any products not agreed to in advance by the beneficiary.
a. True
b. False - Answer True
When a paper SOA form is used, it must be completed __________ hosting the sales presentation.
, a. Prior to
b. During
c. After - Answer A. Prior to
Brokers/Agents can submit a support ticket online through their Centene Workbench portal.
Select one:
True
False - Answer True
Wellcare does not need to be informed of all marketing/sales events at which plans or materials will be
presented or distributed (Formal & Informal).
Select one:
True
False - Answer False
Which of the following actions are you required to do when contacted regarding an allegation of
noncompliant activity?
a. Speak with the investigator as quickly as possible.
b. Answer all questions honestly and completely.
c. Offer information and documents important to the investigation.
d. All of the above - Answer D. All of the above
Key areas you as a broker/agent have control over and impact upon regarding Star Ratings for quality
are:
a. Member Satisfaction/Experience
b. Complaints
c. Rapid Disenrollment
d. All of the above - Answer D. All of the above
Noting the correct enrollment period on enrollment applications helps in preventing delayed enrollment
processing.
Select one:
True
False - Answer True
Health plan fax numbers vary for health plans that offer fax enrollment submissions.
Select one:
True
False - Answer True
Centene requires all contracted brokers/agents to read, understand, and agree to Centene's Business
Ethics and Code of Conduct Policy.
