Category: Eligibility

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 […]

Urgent Coverage Alert for Dually Eligible MassHealth Members

Urgent Coverage Alert for Dually Eligible MassHealth Members –July 19, 2021 Over the fourth of July weekend, MassHealth ended COVID continuous coverage protections for elderly & disabled individuals who are dually eligible for MassHealth and Medicare and who — are no longer eligible for their current MassHealth coverage, are eligible for Medicare Savings Programs also known […]

Past unemployment income

Hello Loopers! Do CACs have to call The Connector to report past unemployment income for a patient who is currently back to work? Or is there a question in the online application asking if the patient previously received unemployment during 2021? I know I read the question was coming soon, but I am not sure […]