Would you ever get locked out of the Web Tool if you put your password in wrong?No, there is no limit on password attempts. |
How can you find out MHN info for a beneficiary?A provider can verify Medical Homes Network enrollment on the eligibility section of the Web Tool under the “Beneficiary Special Program Data” section. |
If a beneficiary isn’t eligible, will the Web Tool show ineligible?Yes, information is listed in red. |
If the Web Tool says they have 2 visits but the beneficiary goes somewhere else, how do we know if they have anymore visits?Web Tool is updated nightly; you should always check and if they are out of visits, let them know before providing services. |
If you are checking a new person’s eligibility, can you add them to your recipient list from that screen?Yes, there is a button to do that. |
Is the Web Tool updated daily?Yes, the Web Tool is updated every night. |
What if a claim is created, but the beneficiary says that he/she no longer has the insurance on file?If a beneficiary no longer has the insurance policy that is seen on the Web Tool, the provider can refer the beneficiary to their eligibility counselor/worker, or complete the Health Insurance Information Referral Form (HIIRF) to update the beneficiary’s third party payer information. Making a change to a policy that already exists in the Medicaid Management Information System (MMIS) takes five days. The HIIRF Form can be faxed to 803-252-0870. |
What is an MHN referral number?If your service requires a referral, the MHN gives you an authorization number. |
When should eligibility be checked?You should check before providing services. |
Will MCO info be available via the Web Tool?A provider can verify Managed Care Organization enrollment on the eligibility section of the Web Tool under the “Beneficiary Special Program Data” section. |