How To Advocate for Clients in a Complex Delivery System

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medical transportation. • Medical services referrals, assessment of needs in ... Chicago, IL 60690-1242 ... To enroll
How To Advocate for Clients in a Complex Delivery System System Pieces

Contact

My client needs: * See term definitions on page 2

Managed Care Organization Care Coordinator

See back of client insurance card for phone number or you can find this online by searching the plan that the client uses.



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Department of Human Services Local Office and Case Manager

DHS Office Locator http:// www.dhs.state.il.us/page.aspx? module=12 Or DHS Help Line (800) 843-6154 or email for faster response [email protected]

Illinois Medicaid Redetermination Project (IMRP)

If your redetermination is being processed by the IMRP, you can:  Fax your documents to (866) 661-7025  Scan and upload your documents at www.Medredes.hfs.illinois. gov  Mail your documents in the postage paid return envelope to the Illinois Medicaid Redetermination Project, PO Box 1242, Chicago, IL 60690-1242

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Referrals to Home and Community Based Services*, Long Term Services and Supports*, medical transportation Medical services referrals, assessment of needs in context of illness, care planning* Help finding behavioral and mental health services

Help with a Medicaid Fee For Service (FFS)* Enrollment issue Help with a redetermination* issue and has both SNAP* and Medicaid Medicaid FFS Eligibility determination To transition between Medicaid programs or eligibility categories Help with redeterminations for Medicaid only Additional time to complete a redetermination Help understanding what documents to provide for redetermination and where to send them if they have Medicaid or a Medicaid health plan without SNAP. Medicaid (only) coverage reinstated

Phone: 1-855-458-4945 Client Enrollment Broker

http://enrollhfs.illinois.gov/ Phone: 1-877-912-8880

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To enroll in a coordinated care or managed care plan Info on provider networks and benefits To opt out of MMAI or change managed care plans

How To Advocate for Clients in a Complex Delivery System Explaining the Jargon Term

Definition

Care Plan

The care plan is developed by the care coordinator and the client. The plan includes the client’s physical, psychological, and social needs, goals, treatment and progress or new needs.

Long Term Services and Supports (LTSS)

Help for older adults and people with disabilities with activities of daily living they would not be able to perform due to a physical, cognitive or chronic health condition. Services and supports can range from assistance with everyday tasks, such as dressing, eating, and household tasks to respite care, emergency response systems, and medical equipment. LTSS is offered in both institutional and home and community based settings.

Home and Community Based Services (HCBS)

Long Term Services and Supports that help older adults and people with disabilities who are on Medicaid to stay in the community.

Medicaid Fee for Service (FFS)

Medicaid provides healthcare for low-income people and families. In Medicaid FFS, providers are paid for each individual service, like a check-up, test, or procedure.

Redeterminations

People who receive Medicaid and/or cash benefits must annually submit proof that they are still eligible for the programs. People will receive their redetermination notices and instructions in the mail.

Supplemental Nutrition Assistance Program (SNAP)

Formerly called Food Stamps, SNAP helps low-income people and families purchase food. Participants get a pre-paid LINK card that they can use at most grocery stores.

For additional information contact Bryce Marable, Health & Disability Advocates Email: [email protected]