Medicaid
QHP
MCO
Policy
Call Center Procedures
100

How many MCOs are offered through HealthChoice ?

What is  9 ?

100

When does SADP stand for?

 What is Stand Alone Dental Plan?

100

What are the abbreviations for Amerigroup and Priority Partners?

What is AG and PP ?

100

Do Outstanding VCLs hold up an application?

What is No?

100

What is the AHT standards for a CSR ?

What is 11 minutes or under ?

200

Who does a consumer call if they receive bills while being active in Medicaid?

What is...

Medicaid Recipient Relations

1-800-492-5231

200

What carriers do we provide here at Maryland Health Connection? 

What is CareFirst and Kaiser ?

200

What are the reasons a consumer can change their MCO ?

What is...

Annual Right

90 Day transfer

Family Unity

Angela Melody



200

How long does an application have to be on file before it is eligible to be escalated?

What is 15 business days ?

200

How many occurrences do you receive when you leave early from work ?

What is if you have more then 4 hours left in your shift it will be 1 occurrence and 1/2 occurrence if than 4 hours or less remains.

300

How many MCOs are there?

What is

9 ?

300

What is the only QHP that we offer in through exchange, that offers Dental?

What is CareFirst?

300

What is MPC stand for?

What is Maryland Physicians Care ?

300

What is the one reason that someone can not be reinstated ?

What is if they are cancelled due to non-payment ?

300

What are the hours of our Call Center?

What is 8 am to 6 PM ?

400

Ms. Jones called stating that she is CareTaker Reltive for her nephew Timmy and he needs to be renewed. 

What is 90 days of straight Medicaid?

400

Where would you go to locate a consumer's premium and plan details after purchased ?

What is Manage Active Enrollment ?

400

CSR MCT span was 04/26/2019 but missed their MCT span and was Auto-Assigned. Would this consumer be able to switch their MCO?

What is...Yes after 90 days?

400

What 4 ways can a consumer submit a document to their account ?

What is by mail, in person, mobile app or upload to their account online.

400

What is the phone number to Maryland Health Connection?

What is 1-855-642-8572.

500

Can a Household consisting of the Primary in a QHP and the child is in MCHP request for Retro-Medicaid ?

What is NO ?

500

If a consumer calls in on 4-22-19 and they state that they lost there APTC due to not submitting his proof of citizenship. How much time does the consumer have to renew ?

What's is....... they can NOT renew and they have to wait until Open enrollment .

500

If a consumer had Kaiser as a QHP and they are now Medicaid eligible can they have Kaiser as an MCO even if its not offered in that county ?

What is Yes.

500

How many occurrence can a CSR get before they are eligible for termination?

What is 5 occurrences ?

500

Can you give a consumer the address to the call center ?

What is NO ?

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