ACRONYM
EIN
EMPLOYER IDENTIFICATION NUMBER
When verifying a household member or client, the first and last name(s) are required pieces of verification along with what 2 additional identifiers:
· Date of Birth (DOB)
· Last 4 digits of Social Security Number (SSN)
· Provider One ID
· Application ID
· Address
· ACES Client ID
If any household members’ eligibility Renewal End Date(s) is within 60 days of the requested date, do you proceed with address/phone update?
No: refer caller to the HBE to process their review and update demographic information.
If clients have additional questions related to eligibility, renewal date, or termination, transfer the client to whom?
transfer the client to MEDS.
Note: If the inquiry is specifically to complete renewal, refer caller to HBE
Adding or removing an Authorized Representative (AREP)
HBE
QHP
qualified health plan
The Categorically Needy Program (CNP) has one of the largest scopes of care, list a few services included.
· Medical Providers · Dental
· Physical Therapy · Eye exams (glasses for children only)
· Behavioral Health · Prescriptions
· Hospitals · Family Planning for men, women and teens
you are unable to complete the update to access the HOH account in either CSA/HPF to change the address and/or phone number who do you refer to?
transfer the client to MEDS.
Custodial Dispute/Head of Household Issues
(for clients with active eligibility)
MEDS
Callers having difficulty applying online
TPL
Third Party Liability
Clients who wish to pay their CHIP premiums online should create what?
Secure Access Washington (SAW) account
who can change an address and/or phone number?
HOH, spouse or AREP
New application/add a person.
Refer caller to HBE
What does a Navigator / Broker assist client with?
Navigators are trained and certified to help find coverage and select a health plan that works for clients. A Broker is a licensed health benefits professional who can assist in selecting a health insurance plan.
HCS
Home and Community Services
CHIP premium billing statements are sent by the Office of Financial Recovery (OFR) to clients the last Monday of every month, what is the due date of the following month?
are due the 15th of the following month
What is Qualified Individual-One Program?
Program pays for Medicare Part B premiums for non-Medicaid clients. These clients are not eligible for any other type of Apple Health and there is no healthcare coverage through Apple Health
Eligibility review/renewal.
Refer caller to HBE
How can a client access a digital copy of their ProviderOne services card?
WAPlanfinder Mobile APP
AEM
Alien Emergency Medical
Who is proper referral if client has Inquiries on why a client received a premium billing statement?
MEDS
What does Statewide Health Benefits Advisors (SHIBA) assist with?
assist clients with understanding their healthcare coverage options and rights, find affordable health care coverage, evaluate, and compare health insurance plans, and provide unbiased and confidential assistance with Medicare and healthcare choices.
Reporting TPL for CHIP - N13/N33
Transfer to MEDS
If a client was referred/transferred from HBE to MACSC on the same day they were approved for Apple Health and needing medical services and/or medication which skill sets assist and what is the request called?
Client Basic trained staff, transfer to Client Advanced
Client Advanced and higher trained staff, see Earlier Enrollment process.