How can agents be investigated for noncompliant activity?

Prepare for the Wellcare / Centene Annual Certification Training (ACT) Exam. Get ready with flashcards and multiple choice questions, each question has hints and explanations. Ensure your success!

Agents can be investigated for noncompliant activity based on reported suspicions of noncompliance because this method allows individuals—such as employees, clients, or other agents—to bring forth concerns or evidence regarding an agent's behavior that may violate compliance regulations or ethical standards. When specific suspicions are reported, it prompts a thorough investigation to assess the validity of these claims and to ensure adherence to laws and company policies. This proactive approach plays a critical role in maintaining compliance within the organization, ensuring that any potential wrongdoing is addressed promptly and effectively.

The other options provide valuable methods to assess compliance, but they do not involve direct reporting. Member feedback can highlight issues but may not always indicate noncompliance directly. Random audits are systematic reviews that can uncover noncompliance but are less dependent on immediate reports of suspicious behavior. Internal system checks are important for routine oversight but also don’t rely on reports from individuals about noncompliance. Thus, reported suspicions directly enable timely investigations based on specific, actionable information.

Subscribe

Get the latest from Examzify

You can unsubscribe at any time. Read our privacy policy