Examples of Eligible Beneficiaries in a sentence
Comprehensive health assessments for newly enrolled CCI Eligible Beneficiaries into a plan.
For CCI Eligible Beneficiaries who are now being mandatorily enrolled in Medi-Cal managed care and do not make an affirmative choice, and after repeated efforts (letter, followed by at least 2 phone calls) to encourage choice, the State will identify individual claims and data (from Medi-Cal and, where appropriate, Medicare) to make a default selection into a plan based on usual and known sources of care, including previous providers (including prescribing providers), and utilization history.
For MSSP and all 1915(c) HCBS waiver programs which CCI Eligible Beneficiaries will be enrolled, the service plan will reflect the participant’s or caregiver’s needs and preferences and address how their needs will be met by a combination of covered services and available community supports.
Dually Eligible Beneficiaries When a dually eligible beneficiary also has a commercialpayer, the provider should file to all payers before filing to Medicaid.
Determining the Number of Potentially Eligible Beneficiaries: The number of potentially eligible beneficiaries by racial or ethnic category for the area served by each sponsor is to be determined each year.