Medicaid Eligibility – Facility Contacts, Escalations & Eligibility Renewals
The overall Medicaid Eligibility process has been met with many challenges including, but not limited to, lack of access to the MEW, inability to obtain application status information and poor communication regarding ME recertification.
Last week, HHSC completed Eligibility staff re-training to improve upon the overall process including escalations and tool walkthroughs for the clerks, supervisors and program managers. The Commission has assigned a staff member as the agency liaison for each Nursing Facility in Texas. This Facility Contact is available today to assist your staff in answering questions related to any of your Medicaid pending residents.
In the past, there was no clear escalation point when eligibility questions went unresolved – now HHSC has a clear route established and will be providing contact numbers for each NF to have improved access to the Facility Contact, their Supervisor, and the Program Manager that oversees the area. THCA has worked with the commission to provide you with a comprehensive listing of these contacts which is available for download via the link below.
As a result of THCA & Provider discussions with HHSC, they now recognize down stream impacts as a result of missed Medicaid Eligibility recertification. To alleviate some of these issues, the Commission is offering an interim solution which will provide a listing of all Medicaid renewal dates upon request (reach out to your Facility Contact to obtain this list).
QIPP Resources Posted
New QIPP resources have been posted on the HHSC QIPP webpage:
- Quarterly QIPP QM Payment Timeframes (PDF)
- Monthly QAPI Submission Payment Timeframes (PDF)
- Nursing Facility Provider Webinar Presentation (Aug. 17, 2017) (PDF)
Email questions or concerns to QIPP@hhsc.state.tx.us.
Upcoming MCO Trainings
- Molina – Friday, September 8, 2017 @ 10:00am CST
- US Toll Free: 855-665-4629
- Meeting Number: 804 900 468
- https://molina.webex.com/molina/j. php?MTID=mbe84d68ebaf0dcf0901215cdad587621
- Amerigroup – Wednesday, September 20, 2017 @ 12:00 pm CST
- Call line: 1-866-308-0254
- Participant code: 817 456 6720
- Meeting number: 593 122 050
- Event password: September20
- Call line: 1-866-308-0254 Participant code: 817 456 6720
- https://antheminc.webex.com/antheminc/ j.php?MTID=m8062b25ca14c6039245d4803254175f2
- Cigna HealthSpring – Thursday, September 21, 2017 @ 9:30 am CST
- RSVP Required – Provider_Training@HealthSpring.com