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Complete discussion and overview of common subject matter. Also includes a Sample Practice Test. In other words, this study course only laser-focuses on the most relevant test topics so that you do not end up wasting your precious time studying for items not typically associated with this type of examination. Plus, you will feel way more comfortable taking the real exam. And it is available to you today as an instant download. The book is transcribed into PDF file format, thus enabling you to get it right now. As a result, you will not have to wait for some generic book to arrive by mail, nor waste your time wandering around in a bookstore trying to figure out what book is right for you. Click Here to Take a FREE Practice Sample Quiz! Be sure to watch the above video as it summarizes everything that is included in this exam preparation material. Everything you need to know is included and will assist you in preparing for the Medicaid Eligibility Specialist exam. Don't waste hours studying irrelevant information when you can use a study system that is geared towards your specific examination. As a result, you can begin your test prep in just a few seconds from now! No outside organization, person(s) or images used here has any affiliation nor endorses any of the products or information provided. All content on this website is copyrighted and protected by U.S. and international copyright law. Use without written permission from the owners of this website is in violation of the law holding our right to take legal action. Resume SamplesIt’s actually very simple. Tailor your resume by picking relevant responsibilities from the examples below and then add your accomplishments. This way, you can position yourself in the best way to get hired. No need to think about design details.No need to think about design details.Include employer, job title, and duration.Are you willing to accept this as a condition of employment?
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Work on programs such as but not limited toProvides input to training manager, trainersPeriod calibration session may occur to re-establish baselines especially for individual training plan assistanceThis helps identify modifications that may be need in training program focus in support of organization's strategic objectivesRequires mastery of EAZ manual, ACES manual and other materials published by the agency related to medical program eligibilityDevelop and provide training on identified performance gaps.Note: This measure is impacted by the number of trained staff available in PEB Division PCS. In addition, the CSL will be re-evaluated during this review period to align with the Result HCA goals for calls answeredScreen, interview, recommend and hire prospective candidates for employmentAlign staff positions and duties within their job classificationsDocument staff performance in supervisor file during evaluation periodMentor and provide leadership for staff growth. Monitor staff work to ensure adherence to daily schedule: ensure that members' calls are answered timely, accurately and courteously, walk-in members receive timely and accurate services, documents are processed within established turnaround guidelines and account information is accurate and consistent with WACs, rules, PEBB Program policies and proceduresAbility to achieve results and stay calm under stressful circumstances. Failing to plan properly can result in financial devastation. A nominating committee is appointed at the expiration of a member's term to recommend potential replacements and the board members are chosen through a fair election process without any tolerance for undue influence. Certified Medicaid Planner Designation Can Boost Your Practice 10000 A day turn 65 70 Have not considered Medicaid Planning 20 Years of experience 9.5 Members rate us Let Us Assist You. You can choose a health plan from those serving MA members in your county. To find out if you qualify, you must apply.
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If you are pregnant, blind or have a disability, you also may have a different income limit. A spenddown is like an insurance deductible. This means you are responsible for some medical bills before MA pays. You must tell us if you have other health insurance or could get coverage through an employer or military service. Some services and prescriptions may require prior approval. Others may have to pay a portion of the cost of a service. This may include copays, deductibles or spenddowns. The Minnesota Department of Human Services (“Department”) supports the use of “People First” language. Although outmoded and offensive terms might be found within documents on the Department’s website, the Department does not endorse these terms. Course topics may include but are not limited to the roles and responsibilities of this position, managed health care, life cycle of an insurance claim, legal and regulatory considerations, basic coding regulations, reimbursement issues, claim instructions, medical terminology, filing commercial claims, insurance plans, Medicare, Medicaid, Tricare and Workmen’s Compensation. Pre-requisite documentation is required prior to registration. Knowledge and Abilities Knowledge of: department, State and Federal rules and regulations, medical and dental terminology, anatomy and pharmaceuticals; principles of employee development, effective supervision and public relations; basic principles of administration, personnel management and organization; data processing. Legal Requirement(s) There may be instances where individual positions must have additional licenses or certification.
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Desirable Qualifications A Bachelor's degree Class Specification History New class: 5-1-68 Revised minimum qualifications: 3-8-71 Revised definition and minimum qualifications; adds distinguishing characteristics: 3-10-78 Revised definition and distinguishing characteristics: 9-10-82 Revised minimum qualifications: 11-14-83 Revised definition and distinguishing characteristics: 3-3-86 Revises definition and minimum qualifications, and deletes distinguishing characteristics. Revises code (formerly 4704) and title (formerly Medical Claims Examiner 4): 6-9-89 Revised definition, distinguishing characteristics and minimum qualifications; title change (formerly Medical Claims Examiner 5): 11-19-98 New class code: (formerly 46380) effective July 1, 2007. Advanced certification produces higher salaries for medical coders and will help you work more effectively within your industry. Position yourself or your organization as an industry leader with a reputation for excellence. Coding specialists review patients' records and assign numeric codes for each diagnosis.Coding specialists review patients' records and assign numeric codes for each diagnosis.Although these individuals perform different jobs, the role of ensuring the accuracy of OASIS data is the same for all of them. To effectively ensure the accuracy of OASIS data, they must understand and apply the instructions contained in the OASIS Guidance Manual, category- specific questions and answers, and quarterly updates provided by the Centers for Medicare and Medicaid Services (CMS). The program covers medical care like doctor visits, prescription medicine, mental health care, dental care, hospitalizations, and surgeries at little or no cost. Children who are wards of the State, receiving adoption assistance, foster children and former. Members normally served in Traditional Medicaid include individuals eligible for both Medicare and Medicaid, individuals who.
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The Healthy Indiana Plan uses a proven, consumer-driven approach that requires you to make a minimal monthly contribution to your coverage based. The program covers medical care like doctor visits, prescription medicine, mental health care, dental care, hospitalizations, and surgeries at little or no cost. The Healthy Indiana Plan uses a proven, consumer-driven approach that requires you to make a minimal monthly contribution to your coverage based. Children who are wards of the State, receiving adoption assistance, foster children and former. Members normally served in Traditional Medicaid include individuals eligible for both Medicare and Medicaid, individuals who. Children who are wards of the State, receiving adoption assistance, foster children and former. Members normally served in Traditional Medicaid include individuals eligible for both Medicare and Medicaid, individuals who. The AMHH HCBS program provides services to adults with serious mental illness who reside in a HCBS setting and who may. The HCBS waiver is designed to provide services to supplement informal supports for. The CMHW HCBS program provides services to youth, ages 6-17, who have a diagnosis of a serious emotional disturbance (SED). The pilot part of this new process will begin July 1, 2019, so you may see your provider use the new system soon. This waiver is designed. The Healthy Indiana Plan uses a proven, consumer-driven approach that requires you to make a minimal monthly contribution to your coverage based. Children who are wards of the State, receiving adoption assistance, foster children and former. The program covers medical care like doctor visits, prescription medicine, mental health care, dental care, hospitalizations, and surgeries at little or no cost. Members normally served in Traditional Medicaid include individuals eligible for both Medicare and Medicaid, individuals who. Some members will qualify for both Traditional.
SHIP is provided by the Administration on Community Living and the Indiana Department of Insurance. There are several different Medicaid programs, each with slightly different eligibility requirements. If you think you may be eligible, the best thing to do is apply. The goal of PE is to make sure that those who appear eligible, based on basic. You can use the Eligibility Guide by selecting the category that best describes you or the person needing medical coverage. Find out more about health plan options and how to contact them. In order for the State to discuss your case or history with your representative, you will need to give written permission. Some specialized services require that you see or call your doctor before you receive them. Some services will require your doctor to request a prior authorization (PA) before the service can be delivered. It is up to the provider to request the PA on your behalf. The table below summarizes these services and copay amounts, by program. Call 855-442-3234 FIND CARE Access a variety of care options.Learn about how to apply and what to expect as a new member. Eligibility and applying Medicaid handbook Integrated Care handbook download our handbooks These guides will help you understand your coverage, benefits, and rights and responsibilities as a Community Care member. See all handbooks search for providers Find a family doctor, specialist, mental healthcare provider, pharmacy, or hospital nearest you. Download Medicaid drug list get to know your plan Get more from your plan. Learn about what's covered and how we can help you. Know what your rights are and how to appeal. Free resources are available if you need a ride to your doctor's office when it's not an emergency. Assistance programs see common questions View our list of frequently asked questions and definitions to commonly used insurance terms.
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Read our FAQs access member forms All of our forms in one place—including forms for claim reimbursement, appeals, and grievances. Search member forms Important Links Notices Other Links Machine Readable Data Contact Us 800-538-5038 SelectHealth. All rights reserved.Call 844-442-4106. Certified DME specialists are highly valued in the industry as an assurance to patients and as trusted sources of professionalism and quality care. The CDME Scope of Practice provides greater detail regarding the role of a BOC-certified DME Specialist. A CDME will provide additional assurance of compliance. An eligible candidate will have a verifiable minimum of 500 hours (approximately 13 weeks of full-time work) of documented experience at a DME facility. For auditing purposes, candidates should maintain and keep readily available attestation from a supervisor. Be sure to thoroughly prepare and review all the documentation that will be submitted with your application. Submit your certification fees with your application; only the application fee is required for application processing. Questions? Contact us. BOC offers year-round testing for all computer-based exams, which means you don’t have to wait for a testing window. Use the CDME Detailed Content Outline to prepare for the exam. BOC’s test delivery provider, PSI, offers two test delivery options: Choose your testing location from the list on the PSI website when you schedule your exam. Make your appointment with PSI at least three business days prior to your desired test date. Please schedule with PSI at least 24 hours prior to your desired test date. Learn more. Once your have earned your certification, you must meet continuing education requirements and renew your certification annually. Yes, state employees are eligible for Health First Colorado (Colorado’s Medicaid Program) if they meet the income and eligibility rules.
Health First Colorado (Colorado’s Medicaid Program) does not have an enrollment fee, but in some circumstances co-pays may be required. Health First Colorado members who are pregnant, living in a nursing facility, or age 18 and younger do not have to pay co-pays. For more information on co-pays, visit the Benefits and Services Overview page. Health Care Colorado covers two 90-day courses of smoking cessation medication with counseling to help you quit. Health First Colorado (Colorado’s Medicaid Program) covers smoking cessation products (e.g. Chantix, nicotine patches and nicotine gum) with a prior authorization. Will Health First Colorado pay for a translator during my doctor visits. Translators are not a Health First Colorado (Colorado’s Medicaid program) benefit. Doctors and other medical providers must offer effective communication with their patients. Effective communication includes translators, American Sign Language interpreters, written material in another language, or other options to help people who speak a language other than English and for people with a disability. For more information, contact the Americans with Disabilities Act (ADA) Coordinator. It may take up to 45 days — or up to 90 days if the application requires a disability determination — from the date your application was received for a case number to be assigned to you. Once you are assigned a case number, you can check your status and benefits online through Colorado PEAK. Get more information about your case number and where to find it. You can submit a written request to receive copies of medical claims paid by Health First Colorado (Colorado’s Medicaid program) to our Privacy Officer using our Access to Protected Health Information form. Legal Guardian, Power of Attorney, or equivalent may sign on behalf of adult.
Documentation is required The Department will act on your request within 30 days (60 days if the information is off site), unless we provide you with notification in writing that a 30-day extension is needed. You may want us to speak with or share your health information with someone you choose to assist you with your Medical Assistance Program benefits. This authorization does not expire unless you choose an expiration date. You will need to sign the form, have your Personal Representative sign the form and return it together with copies of your identification. This authorization expires in 1 year, unless you choose an expiration date. You will need to sign the form and return it together with copies of your identification. See the Apply Now page. If your income has changed or you’ve moved out of Colorado since you applied for Health First Colorado it is important that you update the information we have on file for you. You can also report a change to your local County Human Services Office or a Medical Assistance Site in your community. Depending on your income, you can still qualify for Health First Colorado even if you have private health insurance through your employer. If you have both private health insurance and Health First Colorado, your private health plan will pay your medical costs first, and then what is left over may be covered by Health First Colorado. If you still qualify for Health First Colorado, but do not want Health First Colorado coverage, you can contact your local County Human Services Office and ask them to close your case. The letter will tell you the date that your benefits will end as well as how you can appeal the decision if you do not agree. Health First Colorado (Colorado’s Medicaid Program) has two managed care plans: Denver Health Medicaid Choice and Rocky Mountain Health Plans Prime. These plans are available to members in certain counties. Learn more about managed care plans (also available in Spanish ).
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You may opt out of your Health First Colorado managed care plan for any reason during the first 90 days of your enrollment. You can also opt out each year during your open enrollment, which is the two months before your birth month. You can also opt out of your health plan at any time if you have good cause. Some examples of good cause might be: You will still belong to a regional organization that can help you with physical and behavioral benefits. You can change your Primary Care Provider (PCP) at any time by visiting enroll.healthfirstcolorado.com or calling 303-839-2120 or 888-367-6557. Call Monday to Friday, 8 a.m. to 5 p.m. The call is free. If your physical health plan is Rocky Prime, tell your provider you want to keep him or her. The Health First Colorado mobile app is not for people who want to apply for benefits. With the mobile app and a PEAK Account you can: The card will take up to two weeks to arrive. When calling, choose option 5 to speak to a representative about ordering a replacement Health First Colorado card. Once you’ve completed the process the card will be mailed to the address on file and should arrive within two weeks. First, you should review the different Health First Colorado plans and decide which one is the best one for you. Visit enroll.healthfirstcolorado.com or call Health First Colorado Enrollment at 303-839-2120 (in Denver) or 1-888-367-6557 (outside of Denver). Hours: Monday-Friday, 8:00 a.m. to 5:00 p.m. (closed state holidays). Note: The Health First Colorado Enrollment number is not for information on benefits or to find out if you qualify. It is for people who earn too much to qualify for Health First Colorado (Colorado’s Medicaid Program), but not enough to pay for private health insurance. See the Child Health Plan Plus page for more information. Medicare is a federal government-sponsored health care program primarily for seniors.
Health First Colorado (Colorado’s Medicaid Program) is health care for low-income families and is managed by both the state and federal governments. Medicare and Health First Colorado differ in terms of who they cover, how they are funded and governed. To find out more about Medicare visit Medicare.gov or call Medicare Customer Service at 1-800-633-4227. If you apply online through PEAK you may find out if you qualify immediately. If you apply by mail, it may take up to 45 days to find out if you qualify. Do I need to include my parents’ income on my Medical Assistance application? Yes. If you are a tax dependent of someone else, you need to include their income information on your application. If you do not know it, you will need to contact that person to get their income information. What do I do if I am out-of-state and need to go to the doctor. If you are temporarily out of the state but still a resident of Colorado, you may receive some Health First Colorado (Colorado’s Medicaid Program) benefits under certain conditions: Health care providers can visit the For Our Providers page for more information. How do I get health care coverage for my newborn. Your baby will then be automatically enrolled in health coverage until his or her first birthday. Once your baby is added to your case and you have their State ID, you are able to take your baby to the doctor. Can I also be enrolled in Health First Colorado? Yes. Veterans who qualify can have both VA health care program coverage and Health First Colorado. To find out if you and your family qualify for Medicaid see How To Apply. When will my new health plan start. If you change your Health First Colorado (Colorado’s Medicaid Program) health plan then your new health plan starts the 1st of the next month. For example, if you change your Health First Colorado health plan on February 6, then your new health plan will start March 1st.
Make sure you have your Health First Colorado card on hand when making your appointment and when you go to your health care provider’s office. Hours: Monday-Friday, 8:00 a.m. to 5:00 p.m. (closed state holidays). Note: The Health First Colorado Enrollment number is not for information on benefits or to find out if you qualify. How can I update my income. This is the fastest and easiest way to tell us about the change in your income. You can get in-person help updating your income using your PEAK account from a Certified Application Assistance Sites in your community. If you do not have a PEAK account, you can create a PEAK Account at any time, even if you did not apply online. If you do still qualify then you do not have to do anything.How do I change my name on my Health First Colorado or Child Health Plan Plus case. There are two ways to report that you have legally changed your name. What should I do? If you suspect your doctor, medical equipment provider, or any other Medicaid provider of fraud, please report it to us. What should I do? If you suspect someone of Health First Colorado (Colorado’s Medicaid Program) member fraud, please report it to us. What are some of the other types of coverage that pay for my services before Health First Colorado. Health First Colorado (Colorado’s Medicaid Program) is the payer of last resort in most situations. This means Health First Colorado pays for services only after any other coverage you may have pays first. If you have health coverage other than Health First Colorado, you should report that information to us.What does this mean. This means your Health First Colorado (Colorado’s Medicaid Program) eligibility is being reviewed to see if anything has changed. The law requires us to determine if those enrolled in Health First Colorado still qualify at least every 12 months. Your redetermination or renewal date is one year from the date you qualified for Health First Colorado.
Near the date your eligibility will be redetermined and you will receive a letter asking you if anything has changed (such as your address, family size or income). If you have questions about your redetermination date please contact your local county human services office or call the Member Contact Center. You can check if your Health First Colorado (Colorado’s Medicaid Program) coverage is active by going to the Colorado PEAK website and clicking on the Check My Benefits button or you can view your card from the Health First Colorado mobile app. Get more information on the How To Apply page. If I think I may qualify for Health First Colorado do I need to apply or will I be automatically enrolled. You can apply at any time. For more information visit How To Apply. If you lose Health First Colorado (Colorado’s Medicaid Program) and then get it back within 60 days, Health First Colorado will keep you enrolled in the health plan you had before you lost it. If you lose coverage and it takes longer than 60 days to get it back, you may have to re-enroll in the health plan you had before you lost coverage. Hours: Monday-Friday, 8:00 a.m. to 5:00 p.m. (closed state holidays). Note: The Health First Colorado Enrollment number is not for information on benefits or to find out if you qualify. Health plans are networks of physicians, hospitals, and other health care professionals who deliver medical services to health plan members. To enroll in a Health First Colorado (Colorado’s Medicaid Program) health plan, visit enroll.healthfirstcolorado.com or call Health First Colorado Enrollment at 303-839-2120 (in Denver) or 1-888-367-6557 (outside of Denver). Hours: Monday-Friday, 8:00 a.m. to 5:00 p.m. (closed state holidays). Note: The Health First Colorado Enrollment number is not for information on benefits or to find out if you qualify.
Some Health First Colorado (Colorado’s Medicaid Program) services and benefits require a health care provider to complete a form or make a phone call that gives permission to get extra services and supplies if you have a special health care need. If you have questions about prior authorizations please contact your health care provider or the Member Contact Center. Federal law requires states to operate an Estate Recovery Program to help pay for the costs of their Medicaid program. We recover medical assistance payments paid on behalf of former Health First Colorado (Colorado’s Medicaid Program) members from their estates. We may only recover medical assistance costs from the estates of members who received services in an institutionalized setting or for the cost of services received by members who were age 55 and older. The law also provides exceptions to estate recovery and the ability to compromise claims. Health First Colorado Enrollment is a state program that helps Health First Colorado members choose the health plan they want to get services from. Health First Colorado Enrollment sends letters to all newly enrolled Health First Colorado members letting them know about their health plan options. Hours: Monday-Friday, 8:00 a.m. to 5:00 p.m. (closed state holidays). The Health First Colorado Enrollment number is not for information on benefits or to find out if you qualify. Health First Colorado (Colorado’s Medicaid Program) is free or low cost public health insurance for Coloradans who qualify. Health First Colorado can cover your doctor visits, emergency care, preventive care such as screenings and immunizations, and other procedures and treatments.Managed care is a group of doctors, clinics, hospitals, pharmacies and other providers who work together to take care of your health care needs. We refer to these groups as Managed Care Organizations or MCOs. For more information please see the Accountable Care Collaborative page.
Your Case Number is how we identify you and members of your household in our system. It is also on all letters we send you. You will need your Case Number to find out if you qualify for financial assistance to help buy private health insurance through Connect for Health Colorado. We give each person who qualifies for Health First Colorado (Colorado’s Medicaid Program) an ID Number. Your and your family or caretaker’s Health First Colorado ID Number is sometimes called your State ID Number. Your ID Number is on your Health First Colorado card. It is also on all letters we send you about your benefits. You can also get your Health First Colorado ID Number by calling or visiting your county of residence’s human services office or calling the Member Contact Center. If you are not feeling well but are not sure if you need to go to the doctor, call the Nurse Advice Line at 1-800-283-3221. This free hotline is just for Health First Colorado (Colorado’s Medicaid Program) members and you can call it 24-hours a day, 7 days a week. Help is available in both English and Spanish. Health First Colorado (Colorado’s Medicaid Program) offers services including nursing facility care and Home and Community-Based Services where medical providers come into the home to render the necessary services to keep a disabled or aged individual from being placed in a nursing facility or hospital.After finding out you qualify for Health First Colorado (Colorado’s Medicaid Program) your benefits will start right away. Your benefits may also be backdated to the first day of the month you applied. If you applied for long-term care Health First Colorado or other special programs, your benefits start the day you meet all the requirements. This hotline is just for Health First Colorado members and you can call it 24 hours a day, 7 days a week. Your card will be sent to the address on your application. You can also print your Health First Colorado card through PEAK.