Ambetter
What type of plan is the Ambetter product?
Exchange/Market Place Insurance
Centene is PHW parent or sister company?
Parent Company
What type of plan is the Wellcare product?
Medicare Advantage
What does PHW stand for?
PA Health & Wellness
What do CHC stand for ?
Community Health Choices
Payor ID?
68069
How do we refer to our internal provider based tool?
The Provider Portal
What do the CHC plan provide?
This plan provides quality healthcare coverage with daily support and services.
...partnering with local organizations to offer programs and services when and where they are needed.
All Benefits have cost shares in the form of?
Copays, Coinsurance, and Deductibles.
Who is the VP for Centene's Network Development & Contracting at the Pennsylvania's plan?
Denny Moody
Medicare beneficiaries have the option to stay in the original fee-for-service Medicare Plan or?
Choose a Medicare Health Plan
What's the name of our Claims System?
Amisys
What do CHC cover?
CHC covers the same Physical Health and Behavioral Health Benefits that are part of the Medicaid Adult Benefit Package today.
What logos are on the Ambetter Mbr ID Card?
Ambetter & PHW
How many days do you have to satisfy a NPO?
30 dys
When can Advantage Members change PCPs?
Anytime they please... The changes will take effect on the first day of the month.
When submitting a timely filing project you need to have the provider to complete a ?
Within 30 days of enrollment, PHW will conduct a needs screening using a tool approved by the Department to identify?
Unmet needs
Healthcare needs requiring chronic condition or disease management
Service gaps
Need for Service Coordination
What tiers do Ambetter come in?
Platinum, Gold, Silver, & Bronze
Centene's Chief Executive Officer
Sarah London
Do the Wellcare plan have tiers?
No
What's PHW EDI email address?
Email: EDIBA@centene.com
What is the Person Centered Service Plan (PCSP)?
The Comprehensive Needs Assessment results will be documented and support the development of the Person Centered Service Plan (PCSP).