Value Added Services and Extra Benefits
What are you are able to get extra services in addition to your regular benefits?
What is Value Added Services.
What does HOP stand for?
What is Healthy Opportunities Program.
Appeals must be filed within _ days from the date of the notification of adverse benefit determination (NABD).
What is 60 days?
True or False: Tailored Plans will cover the same physcial health services as Standard Plans.
What is True.
How many Value Added Services does CCH offer?
What is 25.
Who implemented this program as a pilot in select counties?
What is North Carolina, Department of Health and Human Services.
What is the resolution process?
What is 30 calendar days for standard or 72 hours for expedited appeals request.
___________ is a collection of information and tools specifically designed to assist providers transitioning to NC Medicaid Managed Care.
What is the Provider Playbook.
Does Carolina Complete Health offer emergency and non-emergency transportation?
What is Yes.
What is the HOP Pilot Program?
What is a new federally-funded program to help improve the overall health of Medicaid beneficiaries. The goal is to help people who are struggling with housing stability, food security, transportation, and safety.
How/Where to submit Grievance & Appeals Request?
What is:
If a provider is already contacted with CCH for Standard Plans. do they need to join the network for Tailored Plan to provide physical health services to TP members?
What is if you do not have a contract for the Tailored Plan network, you will be considered "out-of-network" and could be subject to reduced reimbursement rates for physical health services.
Can you name 5 of the Value Added Services?
How do members qualify?
What is
1. Be enrolled in Carolina Complete Health
2. Live in one of the 5 pilot counties, Bladen, Brunswick, Columbus, New Hanover and Pender counties.
3. Have at least one qualifying physical/behavioral health risk
4. Have at least one qualifying social risk factor
What is the 1st step in viewing Appeals and Grievance in OMNI?
What is member search via search bar note Amisys ID U # or reference #.
If a practice currently does not have a contract with CCH and decides to contact for the Tailored Plan, will they be able to see CCH patients under the Standard Plan
What is to be considered "in-network" and eligible for the full reimbursement rate for physical health services for Standard Plan members, providers should also be contracted with CCH for Standard Plan.
What are we currently advising members waiting on VAS related deliveries?
What is TAT is currently 6-8 weeks due to the vendor delay.
How does the online form from HOP get delivered to CCH?
What is this form will send your message to Carolina Complete Health as an email. The email is not encrypted and is not transmitted in a secured format. By communicating with Carolina Complete Health through email, you accept associated risks. Carolina Complete Health does not accept responsibility or liability for any loss or damage arising from the use of email. To ensure the safety of your PHI, please send us a message through the Secure Member portal.
What step must be completed 1st before opening the issue intent?
What is review and complete the medical authorization inquiry, pharmacy authorization inquiry or claim.
What additional coverage does Tailored Plans offer?
What is specialized services for individuals with significant behavioral health conditions.