Author: Karen Baumbach

TMA and transition from MH to Connector

We are currently experiencing a number of families who are coming to the end of their TMA benefits.  Upon updating information in the online system as requested by MassHealth, folks who should be transitioning over to a ConnectorCare plan are still being determined eligible for MassHealth Standard.  Due to the MassHealth determination, we are unable […]

ACO

I have reached out to folks at Masshealth directly on this issue, but while I am waiting for a response, I wonder if anyone In The Loop has had any experience with this. I have a client who is on  MASSHEALTH STANDARD PLUS MFP COMMUNITY LIVING HCBS WAIVER.  Her PCP is contracted with Berkshire Fallon Health […]

patient discharge

Hi everyone, I am asking a question for a local physician’s office.  They are in the process of discharging a patient from their practice and are currently listed as the PCP on the members MassHealth Primary Care Clinician Plan. They would like to contact MassHealth to be officially removed as the PCP, has anyone ever […]

letters

In the past two days we have received first, a batch of letters from the Health Connector regarding denial of coverage sighting that the member does not qualify because: “Your application for Health Connector Coverage was withdrawn” Today we received a batch of letters from Masshealth for the same individuals. If I received one letter, […]

Tax forms

I am receiving calls from folks who are getting 1095Bs from Masshealth indicating that they had MH coverage for Jan, Feb, Mar and April when in fact we enrolled them in ConnectorCare plans for either Jan 1 or Feb 1st. These are the individuals who were placed on MH temp coverage which came to an end on […]