HPE
Hi All… I think I’m out of the loop on this one… I saw a bulletin for case managers about covid flexibilites to move patients to rehab with a hospital presumptive app. Is there an application out there? Do we have to contract? Thanks..
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 […]
Masshealth Faxes
We are having a issues with MH faxes… We fax in an application and get confirmation of the # of pages sent… Then when we call to ask about it, they say they only received some of it. Also, we will call to as about a case, and the fax they are looking at are […]
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 […]
COVID exceptions
Hello Loopers Mass Health CSRs are confused about what they can and can’t accept, again. Yesterday we were told they could not go retro 3 months anymore, today that they could not take verbal income verification. Is anybody else having issues? Can they be updated as to what we are told they are still accepting, […]
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 […]
Immigration document
Hopefully somebody else is experiencing this also! We have people crossing the border who have a document that says “Order of Release on Recognizance”, does MH need this document? Should we scan it? Does it make any difference in the insurance they will get? We have a lot of patients coming in from the border, […]
Monthly copay cap letter
Hello everybody! Today we have had 5 patients with Limited/HSN bringing letters saying that on July 1st they will have a $10.00 copay cap for pharmacy benefits. Did I miss a Mass Health email explaining CACs that this letter was being sent? Is this just for Limited/HSN patients? Should we just tell the patients who […]
MassHealth Protection lifted?
Does anyone know if the MassHealth protection was extended for another 90 days? I had 2 members call and said they received letters for MassHealth and Health Connector requesting Proof of income. 1 of the letters sounded like a Job Update Form, I have not seen a copy of the letter. But the letter stated, […]
ESI or MassHealth
Hi; I have a client was offered a job with ESI. She and her family are currently on MassHealth. My question is because of the pandemic emergency can she keep her MassHealth or does she have to enroll her family in her ESI and maybe keep the MH as secondary coverage. Her ESI would be $500 […]