2025 mlri guideline sheet
Hi… Has the new fpl guideline sheet been released yet? Thanks
Masshealth / Commonhealth
I have a client that is on SS disability. We did a MH application but he was not approved for Commonhealth because they want a MH disability supplement completed. Is this correct? He is deemed disabled by SS already. Thanks…
Senior Buy In Coverage
Is there a link to any info what services are covered by Senior Buy In? I know the letter says it covers Medicare Ded/Coins/Copays … I try to generally explain that if it’s not covered by Medicare, the balance is not eligible for Sr Buy In. But I’m getting questions about Copays in a SNF. […]
Commonhealth over 10 years
I have come across a few clients that did their CH renewal and were downgraded or term’d. They did not provide paystubs or the working letter. They were on CH for over 10 years. We call MH and they send it to a supervisor to fix. Today a rep advised we write “Commonhealth” on the […]
New Sr Buy In Decision
I’ve come across a couple patients that were on HSN and MH has rerun the case and they are now approved for Sr Buy eff 4/1. The HSN is terminated eff 3/3/24. Shouldn’t HSN go thru 3/31?
MH Enrollment Choices
I have given up the online enrollment and returned to faxing in a written enrollment. Almost every time, the correct plan enrollment is done and the wrong physician is added. It’s frustrating that its become the new normal for me to explain to the client that this will likely happen, then I have to […]
Premium Assist Problems
I have a commonhealth client that closed her case due to high premiums. When she called us, we found that MH had verified her income at 18K per month instead of 18K annually. The process to fix this is ridiculous. I spent over an hour yesterday for them to tell me they cannot waive it […]
Commonhealth Premiums
If both members of the household are on Commonhealth, is the premium doubled? I always thought the premium was based on total family income. I had a client call that has a 100.00 premium, and his wife is now eligible as well and a MH rep said it would be double.
HSN question
Hi All…. I had a pt tell me they had high medical bills and got approved for MH. They stated the facility applied separately for HSN for the days before the MH was approved. (not the 10 day retro) Is this a thing???
CAC Designation forms
Question… We got a call that they are no longer accepting the email confirmation attached to a CAC form… Stating they need is signed by the applicant. We are still doing a majority of applications by phone. Also, on the CAC roles and responsibilities it states you only need to sign a CAC form once, […]