I have a member that we submitted the “Patient Protection Waiver”, they got approved. Do you know how to I get it open to shop for a plan, without calling the Health Connector? Can I just upload it into the portal or do I need to call them? Member is not available to call them […]
I know HIX just had an update and new (optional) sexual orientation and gender questions have been added. Has it been explained why they are collecting this? When I click the “Additional information about MassHealth & the Health Connector’s efforts to improve health equity can be found here” The link brings me to the 1115 […]
Do you know if members received “Retro Enrollment Notices” during the protection? We are having a 90 day retro waiver, claim deny and MassHealth is requesting the retro enrollment notice to show proof it was actually approved. The biller called customer service and was told that the person that enrolled or requested the retro enrollment […]
I just read the email that was sent to us regarding: 23,000 MassHealth Households Reselected for Renewals in June & July 2023… Does this mean that members who may have received a blue envelope, need to do it again? I have been telling members they only need to do it once. I am thinking they […]
Something funny, you know you have worked as a CAC too long when, Today, at work I received a Orange Renewal Senior Application addressed to only me. That someone in my family has recently turned 65 and I have until July 24, 2023 to submit it. Yeah, Thanks – This isn’t true at all. On […]
Is anyone having issues with SACAs not being processed with the correct determination? I had a member fill out a new application. He would qualify for the Senior Buy In. He was denied. When we called to ask why? The customer service was saying that we are wrong and he is over income. I pointed […]
I had a member who is under 65 – apply back in 2012 and get denied for being over income. He is on disability. He wanted to see if he could get approved. At the appointment, I created a HIX application. He got hung up at ID proofing. When calling to unlock the application. CSR […]
I know MA is rolling out the renewals for members. I updated a member’s application yesterday and noticed today they lifted the MA protection, so the member actually qualified for a Connector Plan. Which is fine. However, did all the Federal flexibilities end on April 1? I called MassHealth to ask to “self-attest” to […]
MassHealth put out a provider bulleting talking about the “Hospital-Determined Presumptive Eligibility (HPE)” updated during Covid. It explains the detailed process on how HPE trained CAC’s may determine whether an individual is eligible for HPE application. Is this the same as the HSN Presumptive Determination application? I explained that we as CAC’S can’t do […]
I am working with a client who had BCBS prime and MA 2nd. She entered into a inpatient facility (mental health). Her BCBS termed on 1/2. On 12/29 we enrolled her (online) into the BMC/Wellsense Community, so when the BCBS ended BMC would start with no gap. Trying to be proactive. I know BCBS has […]