Learning Resources
Frequently Asked Questions
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If a Health Insurance Information Referral Form (HIIRF) is completed with no documentation, will the member's TPL record be updated?No, MIVS will further investigate and draft a letterhead showing steps taken. | |
If a member isn’t eligible, will the Web Tool show ineligible?Yes, information is listed in red. | |
How can you get copies of enrollment letters?To receive a copy of a member’s enrollment letter, they may contact Healthy Connections Choices or the member’s plan (that they were enrolled into). | |
How can you find out MHN info for a member?A provider can verify Medical Homes Network enrollment on the eligibility section of the Web Tool under the “Beneficiary Special Program Data” section. | |
How are MCO plans chosen for a member if they are auto-enrolled?The plan is chosen based on the member’s needs, service area, and any needed specialists. | |
Does the Web Tool’s Lists feature allow you to save a member’s prior authorization in a field?No, prior authorization may not be necessary for all services. There is a field for prior authorization. | |
Does a member have to be on Medicaid to qualify for HIPP?No, but they must be Medicaid eligible. | |
Can you accept a member as just a private pay patient even if they have Medicaid?Yes, you just have to let them know before they receive any services. | |
Can I add a member to the TAD if documentation is not approved? | |