UHC Ethics and Compliance Test New Version with 100% verified solutions-2023- 2024 Recent, Exams of Nursing

Download UHC Ethics and Compliance Test New Version with 100% verified solutions-2023- 2024 Recent and more Exams Nursing in PDF only on Docsity! UHC Ethics and Compliance Test New Version with 100% verified solutions-2023- 2024 Recently Updated Rated 5 Stars by the Experts Agent John is planning to conduct a series of events. Some will be strictly educational, others will be formal presentations of specific UnitedHealthcare plans, and others will be informal marketing events where he can generate leads and schedule future in-home marketing appointments. Of the three types of events John plans to conduct, which need to be reported to UnitedHealthcare? **** When completing an enrollment application in LEAN, why is an agent prohibited from entering his or her own email address in a field available for the consumer's email address? The consumer/member would not receive plan related correspondence intended for him/her. Which election period runs from October 15 to December 7 and allows consumers to elect to join a Medicare Advantage Plan or switch to a different plan? Annual Election Period (AEP) Dino, an agent, received a phone call on September 29 from a consumer interested in Medicare Advantage plans for the new plan year. Dino proceeded to verify the consumer's Medicare eligibility, describe the costs and benefit coverage of the plan, and explained that he could not accept an enrollment application until October 15. What did Dino do that was NOT compliant? Dino presented a plan prior to October 1. Mr. and Mrs. Nelson, who are current members, unexpectedly walk into Jake's insurance agency office and ask him to discuss Medicare Advantage Plans. Does Jake need to obtain a Scope of Appointment (SOA) form? Yes, he needs to obtain an SOA from both Mr. and Mrs. Nelson. Which describes the purpose of educational events? Educational events provide objective information about the Medicare program and/or health improvement and wellness. How should agent Erin respond when consumer Mrs. Rose notices that the presented MA Plan has a Star Rating of 2 stars? Erin should tell Mrs. Rose that the plan has received a "Below Average" rating. To sign an Enrollment Application on behalf of a consumer, what authority must the individual have? The individual must be legally authorized in the state in which the consumer resides to act on behalf of the consumer (e.g. Power of Attorney). When marketing UnitedHealthcare Medicare Advantage plans to consumers, which of the following must an agent do? Provide current marketing materials that have been approved by CMS and UnitedHealthcare. What is the definition of Waste? NOT***** Waste includes any practice that results in the provision of services that are not medically necessary. Which of the issues below are examples of Fraud, Waste and/or Abuse? (Select 3) - Falsifying signatures or medical records. - The pharmacy splits the original prescription to receive additional dispensing fees. - Using another person's medical insurance information to obtain prescriptions. Which of the following materials is an agent NOT permitted to display and/or distribute at a marketing/sales event? 5-dollar gift cards to an in-network pharmacy. Rina, a consumer, has requested an appointment with Connor, an agent, to discuss DSNPs. Prior to the appointment Rina completed a Scope of Appointment (SOA) form. On the day of the appointment, Rina brings her friend Shelley, who is Medicare-eligible, to the meeting. Shelley also wants to talk about DSNPs. What should Connor do when he sees both Rina and Shelley at the appointment? Ask Shelley to complete an SOA before the start of the meeting. Educational events allow for which of the following to occur? Provide objective information about the Medicare program and/or health improvement and wellness. Agent Bryan wants to grow his book of business. Which of the following lead generating activities is NOT compliant? At each appointment he asks the consumer for the name and phone number of at least one acquaintance who is 65 or older and calls the referred individual. Which of the following is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures? Mailing a marketing brochure to the consumer via postal mail. As an agent, you must not do which of the following when marketing UnitedHealthcare Medicare Advantage plans to consumers? Use providers or provider groups to distribute printed information comparing benefits of different health plans without approval. By signing the Statement of Understanding, the consumer: Acknowledges that they clearly understand that they are enrolling in a plan, combined with knowing the specific plan in which they are enrolling.