Which of the following can trigger an investigation into an agent's 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!

An investigation into an agent's noncompliant activity can indeed be triggered by both the Complaint Tracking Module (CTM) and grievances. The Complaint Tracking Module serves as a system that monitors and records complaints received regarding agents' behavior or actions. When issues are identified through this module, it serves as a formal mechanism to escalate matters that may require further investigation.

Grievances, on the other hand, are formal complaints raised by members or stakeholders related to the services provided. They reflect concerns that may indicate noncompliance with regulations, policies, or expectations. When a grievance is filed, it initiates a process whereby the situation is reviewed to determine if further action is necessary.

By encompassing both the CTM, which actively logs and manages complaints, and grievances, which formally express dissatisfaction, the combination of these two triggers reinforces the importance of maintaining compliance and accountability among agents. This holistic view allows for a comprehensive response to potential noncompliance.

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