Medicaid
What is the Medicaid FPL for pregnant women and children under age 1?
223%
Which leaf plans are PCP visits not subject to deductibles?
Silver Leaf Premier and Gold Leaf Premier Plan
Which plan has the largest membership in our service area?
Healthfirst
What demographics must you verify HIPAA with?
Full Name and two of the following: DOB, last four digits of SSN, full address, Member ID.
Can domestic partners share APTC?
Yes
Which type of deduction is no longer applicable on Marketplace applications effective 03/07/18?
Tuition & Fees
Individuals with an active M or F student visas are eligible for which coverage?
EP
When you encounter a renewal on the NYSOH and they are H9 eligible you can enroll them into the our personal wellness plan.
False
You must process the renewal as regular Medicaid and enroll them into our regular Healthfirst plan. NYSOH will reach out to them.
You may not exceed 2 minutes and 30 seconds of this.
Hold Time
For individuals who receive cash income, what must a job letter include in order to be valid by the NYSOH?
Company letterhead, gross income, signed and dated by management
What is the Medicaid FPL for 19-20 year old children living with parent?
155%
What are the annual gym membership reimbursement values for EP/QHP members?
Up to $400 per member and $200 for covered spouse annually
MP Appointments should be reassigned to the rightful owners at what time?
In the morning
You must always end a call by stating the following
Is there anything else I can help you with and thank you for choosing Healthfirst.
(Remember that QA Summary & Call closing consists of summarizing to ensure understanding, offering further assistance and utilizing proper closing statement)
Which type of deduction is no longer applicable on Marketplace applications effective 03/07/18?
Tuition & Fees
John received a HARP passive enrollment notice on 08/04/18. What will happen if he disregards the notice?
He will be automatically enrolled into HARP