MMA
What does MMA stand for?
Managed Medical Assistance
What age group is covered by the CMS Health Plan?
Children and young adults under age 0-19
Where are virtual trainings completed?
Centene University/Work Day
What is the most common reason a member is transferred to the MA TP escalation line?
Missed or delayed transportation.
What age groups are eligible for MMA plans?
All ages, including children, adults, and seniors
Does CMS cover the same services as other Medicaid managed care plans?
Yes, plus additional support tailored to complex needs
What is the quality passing score for MAs?
MA's should achieve 90% or higher on all monthly quality departmental audits.
True or False: Same-day ride requests are automatically approved if a member says it’s urgent.
False – they must be reviewed for eligibility and urgency criteria.
Does Florida Medicaid cover dental services?
Yes, dental services are covered by the dental MCO of the member's choosing.
True or False- All CMS members are assigned a Case Manager
True- Case Management is an important aspect of CMS.
Why are Gaps in Care important?
GIC promote better health outcomes and support preventative care.
If I have an appointment tomorrow at 7am, can I schedule my ride today at 11am?
No, transportation vendors require 24hr or more for non-emergency medical trip scheduling
What agency oversees Florida Medicaid?
Agency for Health Care Administration (AHCA)
Name the two types of CMS coverage and their differences
CMS title 19= CMS members under the title 19 FPL guidelines (medicaid eligible
CMS title 21= CMS members not medicaid eligible due to income
For all non Ambetter members, HRA rewards are rewardable every....?
Once, only available for new members within 60 days of coverage
How many non-medical trips are members allowed per month?
Up to 3
How many Florida counties are excluded in Sunshine Health's FL Coverage map?
0 counties. We cover all of FL
If MA receives a dental provider search/escalation, where do we refer the members to?
Liberty Dental
What are the 5 categories within the Member Advocate Goal?
Leadership=One CenTeam
Quality=Mkae it easy to work with us
Inventory=Trusted Parterships
Personal Conduct=Grow From Strength
Training and Career Pathing=Lead Through innovation
True or False- Members can schedule social trips on for weekends.
Yes. Covered non-medical trips are available 7 days a week, 7am – 8pm.