OH
DSNP Members that are aligned with OH MMP get an additional Healthy Food Benefit through Medicaid. How much more do they receive per month?
$25
Of the three contracts, which plan receives the most for Vision Materials (glasses/contacts)?
H0271-028
If a member is enrolled in H5322-033, what are the seven levels of Medicaid you might see?
FBDE, SLMB+, QMB+, QMB, SLMB, QWDI, and QI
Can a member enrolled in H7464-011 have QWDI level Medicaid?
What is the Final Rule?
We must ensure that our members coordinate their benefits and demographics with their Medicaid MCO. We should ask if the member needs assistance in doing so as a final step for every call.
What services does the Choices Waiver provide? And what tab of Community Care can you find approved Waivers?
Services Provided: Adult day, alternative meals service, emergency response system, home care attendant, home delivered meals, home medical equipment and supplies, minor home mods/maintenance and repair service, pest control for physically disabled individuals.
Waivers are found under the Programs Tab in Community Care
If a member has been approved for the Food Assistance Program/SNAP with the State of Michigan, will their Food Benefit be added to the Ucard?
No, it is loaded to the Bridge Card from the State of MI
How much would Humalog 100 ML Unit Cartridge cost the member?
$0 they are on the LIS Buy Down
What three systems are used to Verify a members Medicaid is active?
DMEVs, MARx, MD State Portal
A member on H7464-006 has used all of their dental benefit coverage allotment for the year. What would you suggest to the member?
Their Flex Card for Dental Coverage
If a member has MMP Medicaid which systems are used to update a members permanent address?
Maestro and routed through Macess
What is your marchvision username?
Your work email
How many quarters would a member need to save their HSS Allotment to purchase a Hand-held shower & Installation
3 quarters ($150/quarter X 3 quarters = $450)
Do these members have Navigators? If so, how do we reach them?
Yes, they use UHC at Home
PH. 855-409-7073
Your work email address
A member is requesting transportation that is 30 miles from their home and does NOT need an ambulance. There is NO waiver on file. Who is the Transportation vendor?
The member must contact the County Non Emergency Transportation (NET) via CDJFS
Once we make an update to a permanent address, we must also get the member in touch with the MI Medicaid Office. What is their phone number?
Toll Free: 888-367-6557 or Michigan Health Care Helpline at 1-855-789-5610
If a member were to lose their Medicaid, how long does their Grace Period last?
Six months
Which contract offers Out of Network benefits?
Trick question, none.
If a member is wishing to disenroll from Medicaid. Who should they contact and what is their phone number?
An Asterisk beside the Medication Name on the formulary identifies what?
That the medication is covered ONLY through Medicaid.
If a member is interested in receiving assistance with daily living (eating, errands, and housekeeping) Home Health Care, who do we refer the member to?
Behavioral and Physical Health and Aging Services Administration (BPHASA)
If a member would like to know about their additional MediCAID Transportation benefits. Who would they contact and what is their Phone Number?
Oklahoma Heath Care Authority (800-987-7767 / 800-522-0114)
If a member needs Home Health Aides to perform Physical Therapy what is the hourly limit?
The service must total fewer than 8 hours per day and 35 hours per week
If a member is enrolled in H7464-007 and has Medicaid with Premier VA, they might get a letter advising what? Who should they contact?
That they need to align their Medicaid Coverage by contacting CCC Plus at 844-374-9159