Administrative Care Coordination/Ombudsman Program

443-523-1740

Administrative Care Coordination/Ombudsman Program

Pediatrician consultation mother with daughterThis program provides education and outreach to Medical Assistance (MA) recipients to increase awareness of Medical Assistance Programs.

  • Assists beneficiaries to navigate the Medicaid/HealthChoice Program
  • Serves as a resource for beneficiaries and providers
  • Helps beneficiaries to understand and utilize their Medicaid benefits
  • Educates on the importance of preventive health care and appointment compliance
  • Assists beneficiaries to re-enter the health care system
  • Explains Managed Care Organization (MCO) choices and how to enroll or change
  • Educates/assists with the need to select a primary care provider
  • Assists with coordination of care, access to services and works with the MCOs to ensure beneficiaries receive covered services
  • Assists with billing issues, pharmacy needs, transportation, etc.
  • Investigates disputes between beneficiaries and the Managed Care Organizations (MCOs)
  • Explains beneficiary appeal and grievance rights

Click here for Healthchoice Brochure

 


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