Show Me the State Specifics - VA
855-242-8282
Who is the Queen of FL?
Kimberly
True or False: Balance billing is allowed?
False: Balance billing is NOT allowed.
What SOP would you reference for AZ Case/Care Management?
AZ Support Services
10/27/25
KM1314102
What does CMS stands for?
Centers for Medicare & Medicaid Services
What is VA's Medicaid Program called?
UnitedHealthcare Community Plan of Virginia - Cardinal Care
WHO IS ALWAYS ON CAPS??? YELLING!
RORO
True or False- In the state of AZ member has 30 calendar days to file for a grievance.
False- There is not a filing limit for a grievance. A member may file a grievance at any time; there is not a filing limit for a grievance. The member may communicate a grievance to UHCCP verbally or in writing. UHCCP should attempt to resolve all grievances within 10 days, but no longer than 90 days. All grievances must be documented, tracked and reported back to AHCCCS.
Note:
Appeals & Grievances section)
What does AHCCCS stands for? What is it?
(ACC) is an integrated health insurance plan regulated by the state’s Medicaid agency, Arizona Health Care Cost Containment System (AHCCCS).
What SOP do you reference for "one breath situations."
"Situational Guidelines- One Breath Chat Advocate"-KM1573859
What is the amount of OTC, food, and utilities monthly award for 2026 UHC DSNP VA-Y4 (PPO DSNP)?
OTC, food and utilities
$205 credit for OTC, food and utilities
Who's FAV color is BLUE??
ROBIN
True or False: If member wants to keep the same plan for 2026, they MUST re-enroll to rewew plan?
False.
What does MTBA stands for?
MTBA - Medical Transportation Brokerage of AZ
What does the networkX Std fee Schedule mean?
A list of fees for specific health care services that an insurance company will use to pay doctors and other health care providers.
Name the vendor for VA DSNP Vision benefits.
March Vision
Who might say...? "Mind your own orchard."
BIG APPLEEEEE
True or False; A member can verbally disenroll??
False; They have to submit the request in writing or we can assist them with online assisted disenrollment.
Name the vendor for AZ DSNP vision benefits.
Nationwide Vision (AZ)
KM1243053
What is the source of truth to determine eligibility?
Marx - CMS
What are the (2) 2026 VA DSNP plans that include a $300 allowance for eyewear?
2026 UHC Dual Complete VA-Y4 (PPO D-SNP)
H0421-001-000
2026 UHC Dual Complete VA-Y001 (HMO-POS D-SNP)
H2445-001-000
#CLAPPYLITTLEFINGERS
Kaitlyn
True or False: A listed Authorized Representative is permitted to submit a verbal grievance?
True - Before documenting a VG, CD, OD, or appeal on the member's behalf, there must be an Appointment of Representative Form (AOR Form) on file, or we must obtain the member's verbal authorization.
How many DSNP plans will be avaliable in 2026 for AZ?
2 total -------- 2026 UHC Dual Complete AZ-S001 (HMO-POS D-SNP)
H0321-002-000
2026 UHC Dual Complete AZ-Y001 (HMO-POS D-SNP)
H0321-004-000
What is UNALIGNED and who do we service?
Unaligned - DSNP UHC/Medicaid other MCO - answer only DSNP questions, refer to MCO for Medicaid questions