Frequently Asked Questions


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Frequently Asked Questions

 

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WEB TOOL

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. 

Entry link: Would you ever get locked out of the Web Tool if you put your password in wrong?

WEB TOOL: CHECK ELIGIBILITY

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.

Entry link: How can you find out MHN info for a beneficiary?

If a beneficiary isn’t eligible, will the Web Tool show ineligible?

Yes, information is listed in red.

Entry link: If a beneficiary isn’t eligible, will the Web Tool show ineligible?

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.

Entry link: If the Web Tool says they have 2 visits but the beneficiary goes somewhere else, how do we know if they have anymore visits?

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.

Entry link: If you are checking a new person’s eligibility, can you add them to your recipient list from that screen?

Is the Web Tool updated daily?

Yes, the Web Tool is updated every night.

Entry link: Is the Web Tool updated daily?

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.

Entry link: What if a claim is created, but the beneficiary says that he/she no longer has the insurance on file?

What is an MHN referral number?

If your service requires a referral, the MHN gives you an authorization number.

Entry link: What is an MHN referral number?

When should eligibility be checked?

You should check before providing services.

Entry link: When should eligibility be checked?

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.

Entry link: Will MCO info be available via the Web Tool?


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