Enrollment broker definition

Enrollment broker means the entity the department uses to enroll persons in a managed care organization. The enrollment broker must be conflict free and meet all applicable requirements of state and federal law, including 42 CFR 438.10 as amended to October 16, 2015.

Enrollment broker means an entity that contracts with the state to:

Enrollment broker means the state and/or county-contracted entity that provides enrollment, education, and outreach services; effectuates enrollments and disenrollments

Examples of Enrollment broker in a sentence

• The Enrollment Broker is available to assist members in choosing an MCE.

• The Contractor shall have the ability to warm transfer members to outside entities including the Enrollment Broker, the Division of Family Resources (DFR) and provider offices.

• The Member Services Manager shall oversee the interface with the Enrollment Broker regarding such issues as member enrollment and disenrollment, member PMP assignments and changes, member eligibility and newborn enrollment activities.

• The Contractor shall provide notification to OMPP, to the Enrollment Broker and to its members of any covered services that the Contractor or any of its sub-contractors or networks do not cover on the basis of moral or religious grounds and guidelines for how and where to obtain those services, in accordance with 42 CFR 438.102, which relates to provider-enrollee communications.

• The Member Services Manager must oversee the interface with the Enrollment Broker regarding such issues as member eligibility, enrollment and disenrollment.

More Definitions of Enrollment broker

Enrollment broker means the state and/or county-contracted entity that provides Enrollment, education, and outreach services to Eligible Persons; effectuates Enrollments and Disenrollments in Managed Long Term Care plans; and provides other contracted services on behalf of the SDOH and the LDSS.

Enrollment broker means the state and/or county-contracted entity that provides Enrollment, education, and outreach services to Eligible Persons; effectuates Enrollments and Disenrollments in MMC and FHPlus; and provides other contracted services on behalf of the SDOH and the LDSS.

Enrollment broker means an entity contracting with TDH to carry out specific functions related to Member services (i.e., enrollment/disenrollment, complaints, etc.) under TDH's Medicaid managed care program.

Enrollment broker. An independent broker who enrolls members in the Contractor’s health plan and who is responsible for the operation and documentation of a toll-free member service helpline. The responsibilities of the enrollment broker include, but are not limited to: member education and enrollment, assistance with and tracking of member’s grievance resolution, and may include member marketing and outreach.

Enrollment broker means the entity the department uses to enroll eligible children with a managed care organization. The enrollment broker must be conflict-free and meet all applicable requirements of state and federal law.

Enrollment broker means an independent contractor that enrolls recipients in MEDALLION and is responsible for the operation and documentation of a toll-free recipient service helpline. The responsibilities of the enrollment broker shall include, but not be limited to, recipient education, recipient enrollment, and tracking and resolving recipient complaints, and may include recipient marketing and outreach.

Enrollment broker means the entity the department uses to enroll persons in an MCP. The enrollment broker must be conflict-free and meet all applicable requirements of state and federal law, including 42 CFR 438.10 as amended to July 19, 2022.