Services Provided by the Managed Care Help Line
1-800-643-2273
- A toll-free telephone helpline to provide Medicaid Managed Care recipients with educational information and enrollment services in order to ensure that they understand their health care choices, benefits, and responsibilities.
- Information to recipients regarding the circumstances whereby they maybe excluded from the mandatory Managed Care programs. Information is also provided to recipients regarding when and how they may switch health plans.
- Assistance to recipients on the resolution of non-clinical health related problems and referrals to appropriate resources for the resolution of clinical or billing related issues.
- Information on how to access participating health plans' member services or complaint/grievance departments as well as accessing the Department's Appeals process.
- Appropriate information needed to assist recipients in determining which participating health plan best meets their and their family's needs.
- Triaging of recipient telephone calls to participating health plans' member services departments, local DSS agencies, or the Department's Recipient and Provider Helplines.
- Eligibility information to recipients and providers.
- Assistance to recipients regarding which of the participating health plans a PCP is a member.
- Written material via US Mail to callers requesting additional information.
- Information about EPSDT services, i.e. how to access, scheduling, and related resources.
- Translation services via telephone for recipients requiring information in a language other than English.
- TDD services for the hearing impaired.
- Information to recipients regarding non-covered and carved out services.
- A Health Status Assessment on all HMO enrollments that are processed through the toll-free Managed Care Helpline. These completed Health Status Assessments are forwarded to the participating HMO that the member has selected.