WELLCARE ACT MASTERY EXAM

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WELLCARE ACT MASTERY EXAM

| 60 QUESTIONS AND CORRECT

SOLUTIONS

Question 1: At the end of this course, there will be a

Mastery Exam. Agents must achieve a passing score of 85% or higher to successfully complete this course.

CORRECT ANSWER: True

Question 2: Which of the following statements about

completing telephonic enrollments is FALSE?

CORRECT ANSWER: Must include most of the

required elements necessary to complete the enrollment.

Question 3: Which of the following is not considered a

grievance?

CORRECT ANSWER: A dispute of the appeal of an

organization determination, coverage determination, or a Late Enrollment Penalty (LEP) determination.

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Question 4: Upon completion of the application, you must

provide the beneficiary with the enrollment application confirmation ID.

CORRECT ANSWER: True

Question 5: Which is an example of a top beneficiary

complaint that affects Star Ratings?

CORRECT ANSWER: The beneficiary did not

understand that enrolling in a Wellcare plan would change their current Medicare Advantage plan.

Question 6: Agents may be investigated after being

suspected of noncompliant activity reported through a:

(Select all that apply.)

• Complaint Tracking Module (CTM)
• Grievance
• Secret Shop Finding

CORRECT ANSWER: a, c, d

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Question 7: Low-Income Subsidy (LIS), which is often

referred to as Extra Help, reduces all Part D plan premiums.

CORRECT ANSWER: False

Question 8: Which of the following actions are you

required to do when contacted regarding an allegation of noncompliant activity?

CORRECT ANSWER: All of these

Question 9: 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.)

• First
• Second
• Third

CORRECT ANSWER: a, b, c

Question 10: An agent who has never had any verbal

warnings cannot be issued a Corrective Action Plan.

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CORRECT ANSWER: False

Question 11: When explaining the provider network for

D-SNPs and C-SNPs: (Select all that apply.)

• 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.

CORRECT ANSWER: a, b

Question 12: 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.

CORRECT ANSWER: True

Question 13: 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.