Pdps Study guides, Class notes & Summaries

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 t...

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 t...

WellCare ACT Mastery Exam (Latest 2023/ 2024 Update) Version 3 | Questions and Verified Answers| Grade A| 100% Correct Q: When explaining the provider network for D-SNPs and C-SNPs: Answer: Avoid submitting applications with no primary care provider (PCP) to assist these higher-risk members. If a member is not connected to a primary care provider (PCP), we should always encourage and assist with connecting them with an in-network doctor Q: If a requested effective date is avai...

WellCare ACT Mastery Exam (Latest 2023/ 2024 Update) Version 1 | Questions and Verified Answers| Grade A| 100% Correct Q: Any request or distribution of PHI should contain only the minimum amount of PHI required to complete the intended task. Answer: True Q: Member PHI can be stored on an external hard drive or a cloud storage service like Google Drive or Apple Cloud. Answer: False Q: When completing an enrollment, be sure to use the correct enrollment application fo...

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 o...

Brokers/Agents can access the following resources under the Shared Resources section in Centene Workbench. a.Training Resources b.Commission Resources c.Marketing Resources d.All of these d.All of These Although options for capturing and submitting SOAs vary by health plan, Wellcare accepts SOAs in which of the following methods? a.Ascend b.Telephonic c.Paper d.All of these d.All of These Marketing benefits in a service area where those benefits are not available is prohibite...

Centene requires all contracted brokers/agents to read, understand, and agree to Centene's Business Ethics and Code of Conduct Policy. True False True The TPMO disclaimer must be used by any TPMO that sells plans on behalf of more than one MA plan provider. The disclaimer must be: (Select all that apply.) a. Included in any marketing materials, including print materials and television advertisements developed, used, or distributed by the TPMO. b. Verbally conveyed within the first ...

Enrollment applications must be received by Wellcare no later than ___ calendar day(s) following receipt from the beneficiary. 1 Which elements are available as part of Wellcare's Sales Support model? All of these Low-Income Subsidy (LIS), which is often referred to as Extra Help, reduces all Part D plan premiums False Prior to completing the enrollment form, broker/agents should always confirm the beneficiary's primary care provider (PCP) and/or specialists True ...

2024 WELLCARE MASTERY TEST ACTUAL EXAM 130 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |AGRADE The Mastery Exam will lock for a period of 48 hours after each failed attempt. - ANSWER- False Members who fail to pay the required premiums before the end of the grace period (Wellcare has a three-month grace period) will be terminated. - ANSWER- True True - ANSWER- True Which of the following is not an example of Protected Health Information (PHI)? - ANSWER...

TERM Selection and Enrollment DEFINITION Members use ratings systems to help them choose a plan or decide whether to stay with our plans. LOCATION Image: Selection and Enrollment TERM Reputation DEFINITION Wellcare strives to be an industry-leading organization that is attractive & valuable to our members and to our providers & government partners. LOCATION Image: Reputation TERM Member Service DEFINITION Our first priority is to provide our members with excellent care and...