Show:
Transportation
MHP
HIPAA
Documentation
100

If a member is out of trips how would they get additional rides?

If the member exhausts all trips through Buckeye, they will need to contact Net County at Job and Family Services for additional trips. This can take from 10 to 30 business days for approval.

100

Females age 50-74 can receive $50 for what reward?

An annual breast cancer screening

100

The three caller identifiers are

  • MMIS#
  • Date of birth
  • Last four of social security number (last resort)
  • Address and Phone number (counts as 1 identifier) (last resort)
100

Where would you document a transportation call?

Go to the benefits tab, scroll toward the bottom of the page and click yes under does caller need benefit information, click submit, select medical under benefit tab then select transportation 

200

What rides do not require preapproval from the plan? 

Cardiology, dialysis, surgery, wound care, diabetic/care services, urgent care facility/hospital discharge, Addiction Services: all addiction covered, grocery stores, ob, prenatal services, and neonatology 

200

When can member's earn the reward for the flu vaccine and what is the age range ?

One per flu season September – April, age 6 months and up

200

Where do we check for Auth caller 

Check Special Handling Notes in OMNI

200

Where would you notate a Pharmacy lock in change?

  • Log View Status
    • Pharm lock-in
    • Answer Yes to the question, Is member wanting to submit a request to update their assigned pharmacy?
    • Enter a zero for the pharmacy NPI
300

How would a member schedule stretcher or ambulance services?

Call member services and a representative will fill out the template completely and send to BHP_Member_Advocate_Team@Centene.com. of members details

300

What stores can the MHP Visa card be used at?

Shop at Walmart and Sam's Club

300

If someone calling within Buckeye

verify required PHI, Caller's name, and department in Teams.

300

How would you Document an auth caller?

  • k: Update member demographic
    • Authorized contacts
    • Toggle to update
    • Contact type is always verbal authorization
    • Address used will be the member's address
    • Start date is today
    • End date is 30 days out
    • Select Yes to form requested
    • Template in the three dots at the top


400

How many transportation trips does member get each year? 

20 round trips or 40 one ways  

400

When do my Health Pays rewards expire?

Funds for earned rewards expire 90 days after termination of coverage or 365 days after date reward was earned, whichever comes first.

400

If the caller states they have Legal Guardianship of the member what do we need to do.

ask the caller to fax this information to Buckeye.  Once received, the CSR will follow the PHI verification and speak with the caller.  You can only give general  information (I.e. anything that can be found on www.buckeyehealthplan.com.      

500

If a member has a snt that is greater than 30 miles how would you handle this?

If a member calls and is needing to get to an appointment that is over 30 miles, transfer the member to SafeRide Health for them to handle. SafeRide Health has their process on how to handle a trip over 30 miles. Even if the trip is short notice.

500

What can The my health pays rewards be spent on?

You can buy everyday items with your rewards card up to the balance on the card.

  • The MHP rewards card cannot be used to purchase alcohol, tobacco, firearms, gift cards and fuel.
  • the rewards card can be used towards prescription copays ONLY at Walmart and Sam's Club pharmacies. 

    • The rewards card can be used to pay gas, electric, water and sanitary sewer bills.    
  • The rewards card can be used to pay for telecommunications expenses like cell phone or home phone/land line bills.

    • The rewards card can be used to pay for Rideshare, taxi or public transportation like the bus or train.
  • The rewards card can be used to pay education expenses at Elementary and Secondary (High) Schools, Colleges, Junior Colleges, Universities, Professional Schools, Correspondence Schools, Business and Secretarial Schools, Vocational and Trade Schools.

    • The rewards card can be used to pay for Child Care Services like a commercial day care center.     

    • MHP rewards can be used towards housing/rent if the Real Estate Agent/Manager or Rental Property Management Company accepts debit card payment, and they are classified as a Real Estate Agents and Managers, Rentals, Property Management for processing.      

500

Who are we able to speak to for a minor if there is no auth caller form on file and hippa is verifed. 

Mom/dad, stepparents, foster parents job and family services, or buckeye health plan entity (safe ride, centene vision and dental. etc)

500

How do you document a call from a member interested in joining the plan?

Click other action and select member not found 

  • Fill out as much information as possible in the fields provided:
    • Caller First and Last Name
    • Caller Phone Number
    • Member First Name – Required
    • Member Last Name – Required
    • Member Date of Birth
    • FFM ID Number
    • Policy Number
    • Application ID Number