Hi can I get some clarification in regards to changing a members plan online? Is it effective retro to the date of submission online or not? I believed it was if submitted online but when we go back to check 48-72 hrs later it does not show up as plan taking effect on date of […]
Hello We have been having problems when patients are calling MH to change to Tufts Health together with CHA. Patients are constantly told that our doctors take Tufts Health Together and there is no need to change to our ACO or that they can’t because they live outside of the 25-mile radius even when they say […]
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 […]
Hi everyone, We are using the Masshealth Choices enrollment site to switch patients who were either moved into the wrong ACO plan or not moved at all, into our correct ACO. We are also using the site to switch primary care provider’s for patients, back to our facility who were wrongly assigned. We were told […]
Hi all, When using the MassHealth Provider Directory and MassHealth Choices, I’m finding significant discrepancies between what is shown as contracting/covered providers under different health plans and what hospitals and doctors’ offices report. Is anyone else finding this to be true? I am using the MassHealth tools, then checking it against what the hospitals and […]
Hi All, I’m not sure if I have just missed this in the trainings, but what is a Model A ACO and Model B ACO? I had believed that MassHealth members wouldn’t be able to choose PCPs that were a certain distance from their zip code and was recently informed that the geographic restrictions for ACO […]
Hi, My client did not act on the high-cost plan chosen for her by the HC (over $1,000/month premium for 1 person) until after 12/23/17. We called on 12/26/17 to cancel her January enrollment. Now the HC insists that she owes the payment even though: 1) the plan was cancelled for non payment, so she she did […]
Hey everyone, Has anyone else noticed an issue with CarePlus enrollments done for 2/1 or MCO changes for 2/1? We are noticing that all online enrollments no matter when they were done in January are not showing up as active and only showing MH CarePlus with a need to enroll. Also some people who had […]
Hello, I have a patient that came in yesterday who currently has NHP Careplus. She received the letter from Masshealth Choices about the need to pick a new MCO/ACO and on her letter there was not a suggestion from Masshealth about whom to switch to. She has at least 20 doctors that she sees that […]
Hi, I had four families contact me this week stating they did not receive an invoice from the Connector for December or January. They subsequently lost their coverage although they paid the premiums without the invoice. All their coverages were terminated as of November 30. I checked via the assister portal and all four have 2/1/2018 effective […]