Category: Eligibility

Monthly Report Data Collection

Hi fellow Navigators, My name is Buliah Mae, Lead Navigator for the Hilltown Community Health Centers.  Our three-person team is  currently considering new ways to track our monthly report data and are interested in how other health centers do this. What are the pros and cons? Is the program web based? Is the program customized […]

How to apply for CommonHealth

Happy 2022 everyone.  I have a question regarding a client who is 62 years of age who wants to apply for CommonHealth.  Her spouse is 66 years of age.  Here are some facts: The couple have an active application via the Health Connector.  Both are currently enrolled in a CC plan. The wife has Medicare […]

Exceptions for ACOs/MCOs that are locked into their plans

Hello We have had luck changing patients who are locked into their plans by explaining that they have been our patients for a long period of time and this is used as the “exception”.  Recently, patients who move and are assigned a plan close to their new homes are not being changed back to their […]

Exceptionally Long RFI Processing Times

Hello, Now that we are in OE, there is a bit more urgency to having verification documents processed.  We have noticed that some documents uploaded in Sept/Oct are still outstanding.  Cases have been created to process them more quickly, but even that isn’t happening.  Does anyone have insight on what is happening behind the scenes […]