WellCare ACT Mastery Exam (Latest 2023/ 2024 Update) Version 5 | Questions and Verified Answers| Grade A| 100% Correct
WellCare ACT Mastery Exam (Latest 2023/
2024 Update) Version 5 | Questions and
Verified Answers| Grade A| 100% Correct
Q: Which of the following actions are you required to do when contacted regarding an
allegation of noncompliant activity?
Answer:
All of these
Q: Dual-eligible and LIS beneficiaries that are not at-risk may use a Dual-Eligible SEP once
per each of the __ calendar quarters only.
(Select all that apply.)
Answer:
a. First
b. Second
c. Third
Q: An agent who has never had any verbal warnings cannot be issued a Corrective Action Plan.
Answer:
F
Q: When explaining the provider network for D-SNPs and C-SNPs:
(Select all that apply.)
Answer:
a.
Avoid submitting applications with no primary care provider (PCP) to assist these higher-risk
members.
b.
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: 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:
T
Q: A grievance request, or any evidence concerning a grievance, must be filed 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
Q: When enrolling a D-SNP beneficiary, be sure to verify plan enrollment eligibility and that
the Medicare Savings Program (MSP) level is eligible for the requested plan.
Answer:
T
Q: Key areas you as an agent have control over and impact upon regarding Star Ratings for
quality are:
Answer:
All of these
Q: Lead-generating activities (either directly or indirectly) facilitated by a third-party marketing
organization (TPMO) need to include a notice to the beneficiary that their information may be
shared with a licensed agent for future contact.
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