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.

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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 that contracts with the state to:

Examples of Enrollment broker in a sentence

The Department’s Enrollment broker will automatically reenroll a previously enrolled Medicaid Managed Care Member who was Disenrolled solely because he or she lost Medicaid eligibility for a period of two (2) months or less.
All Enrollment and disenrollment-related requests, including transfers between ICDS Plans, will be accepted and documented to ODM by the Ohio Enrollment broker.
The Department’s Enrollment broker will automatically reenroll into the same plan, a previously enrolled Medicaid Managed Care Member who was Disenrolled solely because he or she lost Medicaid eligibility for a period of two (2) months or less.
All Enrollment and disenrollment- related requests, including transfers between ICDS Plans, will be accepted and documented to ODM by the Ohio Enrollment broker.
The Department has established an Enrollment process for the Medicaid Managed Care Program with a Third-Party Enrollment broker, called South Carolina Healthy Connections Choices (SCHCC).

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 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.

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

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 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 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. 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.