CoventryCares of KY Lock-in-Program.

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Presentation transcript:

CoventryCares of KY Lock-in-Program

Lock-In-Program Start date Lock-In-Program: What is it? How does this affect Avesis and Providers? Identify a member in AbH Identify a member in AcH Keep in Mind Assessment Please click on the links to the left to learning about CoventryCares of KY Lock-in-Program.

Start Date Start date Lock-In-Program: What is it? How does this affect Avesis and Providers? Identify a member in AbH Identify a member in AcH Keep in Mind Assessment Begin date for this change to CoventryCares is 03/01/2013. Letters to providers were mailed out 03/04/2013. We can expect call for this change this week.

Lock-In-Program What is it? Start date Lock-In-Program: What is it? How does this affect Avesis and Providers? Identify a member in AbH Identify a member in AcH Keep in Mind Assessment This program was developed to educate members who may be intentionally or unintentionally misusing Medicaid benefits and to ensure that program funds are used to provide optimum health services for members. Members who misuse pharmacy, and/or emergency department benefits may be restricted to the use of one pharmacy, one physician and/or one hospital.

Avesis & Providers Start date Lock-In-Program: What is it? How does this affect Avesis and Providers? Identify a member in AbH Identify a member in AcH Keep in Mind Assessment If you have a member that is in need of a prescription during dental treatment you will need to either obtain a referral form from the member’s Primary Care Physician (PCP) OR ask the PCP to write the prescription on behalf of the member.

Identify a Member in AbH Start date Lock-In-Program: What is it? How does this affect Avesis and Providers? Identify a member in AbH Identify a member in AcH Keep in Mind Assessment Go Member Eligibility Search. Enter the member information you wish to verify eligibility for and if a member is part of this program then it will state “yes” under the “Intervention” tab next to the “Member Name” as shown below. Then when you click on “yes” it will take you to the Intervention Measure where you can see if the member is part of the CoventryCares Lock-in Program.

Identify a Member in AcH Start date Lock-In-Program: What is it? How does this affect Avesis and Providers? Identify a member in AbH Identify a member in AcH Keep in Mind Assessment Under the Member profile, enter the member ID # and you will receive the following splash page:

Keep in Mind Start date Lock-In-Program: What is it? How does this affect Avesis and Providers? Identify a member in AbH Identify a member in AcH Keep in Mind Assessment This update is only affecting CoventryCares of KY members. The member needs to be in a Lock-in-Program for this update to apply to them. Check AbH or AcH to see if the member is in the Lock-in-Program.

Assessment Start date Lock-In-Program: What is it? How does this affect Avesis and Providers? Identify a member in AbH Identify a member in AcH Keep in Mind Assessment The assessment has to be completed before 6p, Friday, March 8th. Please click on the link below to complete the assessment. You will need your Username and password to complete the assessment. http://www.quia.com/quiz/4149389.html