Keep in mind, we do many home-based visits, so this isnt just about getting patients rides to the office, but at times there can be more opportunities with scheduling via virtual visits. We believe that CCA members' preferences are the most important factor in choosing the site of care, even if some visits end up requiring in-person care later. Plus, we offer long-term help with daily activities to help you live safely and independently athome. <> Do you need health coverage? You are now being transferred to the CCA corporate website. Who is eligible for CCA One Care? Update your contact and other personal information to make sure you stay covered. No. `pV!L2xCC"xZG(p|~~%8cts&(! Plus, we offer long-term help with daily activities to help you live safely and independently at home. Please remove any contact information or personal data from your feedback. We also are focused on providing choice in mode of care and increasing value to ensure that members are getting the care they need in the best way possible. 1 0 obj Ask to be enrolled in the Commonwealth Care Alliance One Care plan. The Americans with Disabilities Act (ADA) is a federal civil rights law that prohibits discrimination against people with disabilities. 4 3urylghu0dqxdo 6hfwlrq .h\&rqwdfw,qirupdwlrq &rqwdfw 7hohskrqh )d[:he ( pdlo &odlpv2iilfh 3 2 %r[ *uhhqodqg 1+ 7ho 77<0dvvdfkxvhwwv5hod\6huylfh Z~VtmH=NoxGfWN}2x+/]Z?TP) _f&34 A_y `)x.Hzu=d-lKqvoi+3g/6ac25m>?D. In addition, we are devoted to training future generations of health professionals in our wide range of residency and fellowship programs. Commonwealth Care Alliance Accepted - SCO and ICO One Care for specialty/referral care only, no primary care. When clinicians schedules can be pooled, or when virtual care can be done during downtime or no-show time, wait times for visits fall dramatically. CCA One Care includes even more comprehensive dental coverage than your MassHealth plan, at no cost to you, including: All of your prescription drugs will be covered at no cost to you. These policies are updated regularly, based on guidance from applicable federal and state regulations, to promote accurate coding, billing, and policy clarification. . Standard Pre-service Appeal: Answered within 7 days, Standard Post-service Appeal: Answered within 14 days, Expedited Appeal: Answered in 72 hours and requires a statement from your doctor indicating an urgent need. To screen these out, our clinicians assess the presence of certain red-flag issues that disqualify a visit from being appropriate when conducted virtually. A Reset font size. The Commonwealth Care Alliance (CCA) network of doctors is very large. Stay up to date with the biggest stories of the day with ANC's 'Dateline Philippines' (22 July 2023) | ABS-CBN News Channel, Philippines Quincy, MA 02171 Managed Care Organization (MCO) - We work with providers across the state to offer MassHealth to our members. Commonwealth Care Alliance Psychiatrists in Massachusetts The Boston Globe Names Commonwealth Care Alliance a Top Place to Work for 2022. How much does CCA One Care cost? Insurances Accepted | Tufts Medical Center What are a couple of success metrics of your telemedicine program? Supported by guidelines and care team members that protect members from unsafe uses of telehealth, we think this approach maintains the customer focus that has long been a part of our history and mission. Are prescription drugs covered? Can I keep my doctors? To improve the health and well-being of people with significant needs by innovating, coordinating, and providing the highest-quality, individualized care. All your services come free of charge as part of your MassHealth and Medicarebenefits. September 18-21, 2023 | Jakarta, Indonesia. Approaches that err on the side of bringing patients in aim to avoid wasted or failed visits. For both in-person and virtual visits, BMC is here to ensure you have everything you need to make your visit a success. If you have any questions about naming your appointed representative, you can call us at 866-610-2273 (TTY 711). This matters not only for urgent care issues, but also when a patient is motivated and wants to secure a visit quickly. The HIMSS 2023 Healthcare Cybersecurity Fall Forum will explore how the industry is fortifying its defenses today and preparing future-ready strategies for tomorrow. within 12 business days to discuss membership options. Enroll in coverage any time of the year if you are applying for dental plans or help paying for health coverage including MassHealth, Children's Medical Security Plan (CMSP), Health Safety Net, or ConnectorCare. Dateline Philippines | ANC (22 July 2023) - Facebook All of the above is within a culture of erring on the side of caution when clinicians have concerns about virtual care, and being empowered to make decisions along with our members that best serve their needs and preferences. To enroll in CCA One Care, you must live in one of these counties in Massachusetts: Barnstable, Berkshire, Bristol, Essex, Franklin, Hampden, Hampshire, Middlesex, Norfolk, Plymouth, Suffolk, and Worcester. 617.638.8000. You could also file a grievance if you do not think we responded quickly enough to your request for coverage determination or organization determination, or to your appeal of that determination. A lock icon ( Learn More About CCA Medicare Advantage Plans, Your Medicare questions answered: Who is eligible, how to apply, and more, How to sign up and manage Medicare coverage when retiring late. A Decrease font size. endobj Theres a good chance your current doctors and other providers are already part of it, and you will not have to make a change. This number continues to grow as a direct result of our efforts to scale virtual care programming during the pandemic. There are two ways you, your doctor, or your appointed representative may file a medical appeal: Members will receive an Appeal Acknowledgement Letter once the appeal has been initiated. If you're 21-64 with complex medical and behavioral health needsincluding physical, developmental, and intellectual disabilities CCA One Care brings together your MassHealth and Medicare benefits. A CMS representative form is valid for one year from the date both parties sign the document. CCA provided interpretation services during 1,602 video visits in 2022, representing 27 different languages, including Spanish, ASL, Vietnamese, Haitian Creole and Cape Verdean Creole. This letter will document the next steps of the appeal process as well as the timeframe within which CCA must respond to the appeal based on the request type (standard vs. expedited). Q. A Reset font size. PDF MassHealth: Senior Care Options Medicare/Medicaid Demonstration Certain symptoms suggestive of heart problems, especially chest pain, shortness of breath, palpitations (lasting more than a few minutes), leg swelling, lightheadedness (except when familiar or typical for the individual). If you need assistance, please For help on some common issues, see here.. Commonwealth Care Alliance (CCA) payment policies are designed to assist providers when submitting claims. April to September, 8 am 8 pm, Monday Friday, A CCA Medicare Professional will call you at. As I mentioned earlier, the confidence of our providers in their ability to offer a positive virtual care experience is another element of our success. 4 0 obj Please limit your input to 500 characters. Boston Medical Center (BMC) is a 514-bed academic medical center located in Boston's historic South End, providing medical care for infants, children, teens and adults. Your disenrollment will be effective on the last day of the month in which you let us know you want to leave the plan. April to September, 8 am 8 pm, Monday Friday, A CCA Medicare Professional will call you at. 3932. For help on some common issues, see here. A Decrease font size. In 2022, we served 25,166 unique members through virtual care ranging from 21 to 105 years of age, totaling 46,886 visits. You will not lose services. The Massachusetts-based Commonwealth Care Alliance (CCA) One Care demonstration program serves individuals ages 21 to 64 who are dually eligible for both Medicare and Medicaid. A .mass.gov website belongs to an official government . Patient enrollment is either opt-in or passive, and there is a specialized intake team who follows a clear protocol for the assessment. A Reset font size. As a CCA One Care (Medicare-Medicaid plan) member, you now get all your MassHealth and Medicare benefits AND MORE. Appeals & Grievances | Commonwealth Care Alliance MA You are now being transferred to the CCA corporate website. 1 When you click this link, you will leave the Commonwealth Care Alliance website. stream A A A. A Increase font size. A .mass.gov website belongs to an official government organization in Massachusetts. In addition to this commitment, our leadership in health equity, research, and teaching is driving the future of care. Notorious not to response or call return. CCA payment policies, as well as our clinical and medical necessity guidelines, are developed in accordance with nationally accepted guides and best practices. Commonwealth Care Alliance Tufts Health Unify UnitedHealthcare Connected Contact Commonwealth Care Alliance One Care Member Information Find a Provider Customer Service: Monday through Friday 8:00am to 8:00pm, Saturday and Sunday 8:00am to 6:00pm Phone: (866) 610-2273, TDD/TTY: 711 Boston, MA 02118 CCA continuously strives to ensure that our services are accessible to individuals with disabilities. Boston Medical Center currently accepts the following insurance plans. <> A Reset font size. Please talk about how all this works with the evaluation and assistance. Why has telemedicine become a priority for the organization? You should always check with your own health insurance plan before getting care to make sure you understand your covered benefits and costs. There are two ways you, your doctor, or an appointed representative may file a pharmacyappeal: Commonwealth Care Alliance If you would like to continue helping us improve Mass.gov, join our user panel to test new features for the site. 8:00 am to 5:00 pm, Monday through Friday. Members must file for a Level 2 appeal with MassHealth directly for Medicaid covered services. try again. You might file a grievance if you had any type of problem with the quality of your medical care, waiting times, or the customer service you receive. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Get daily news updates from Healthcare IT News. Commonwealth Care Alliance (CCA) One Care (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and MassHealth to provide benefits of both programs to enrollees. Submit your complaint directly to Medicare by using their online form1 or by calling 800-MEDICARE (800-633-4227 or TTY 877-486-2048), 24 hours a day, 7 days a week. 30 Winter Street We are happy to say that most members are very satisfied with their CCA One Care experience, and very few people leave the plan. Frequently Asked Questions - Commonwealth Care Alliance MA CCA prioritizes virtual care because access to technology is a social factor that impacts health and it enhances care coordination by engaging members where they are. Micromanaging, too many changes in standards its tough to keep . This uncertainty is an important barrier to expanding and optimizing the use of virtual care, especially for clinicians and patients who are the ones directly involved. If you need assistance accessing our services, we can assist you. If we identify a lack of a reliable device or connectivity, we then work one-on-one with the member to help them secure the necessary supports. 'q5KHqE,`ym K?e_v>zic*v3W![&T0:TE#KWbC&6`.577c^dbRu!HmtiMFQ5v C68MU$NWj{h>2.&CZh>3,c3I4[: 1F'V~C8lK, @7*#=jGHM!hHs:j(SlCXrcBS8h>Xk%j_=YjOO{wQmTE&3@y^an1Y9y1w0 jm`Eop>'E(a{c(Tu)=D:#;KD(AN[\kwk!h8T{yX@y/i}DJu^}cPC0Ci/6^\xc7=^Q{~ZQ9n*fM_6V"u>(? And all healthcare provider organizations can learn from CCA's implementation. saved. If you would like to name a representative to appeal on your behalf, the request must be signed and sent by mail or fax to: Executive Office of Health and Human Services Insurance | Boston Medical Center At Boston Medical Center, research efforts are imperative in allowing us to provide our patients with quality care. For our members with diabetes, heart disease, rheumatic diseases, obesity, high blood pressure and other chronic diseases, virtual care is an excellent way to improve care plan adherence by providing flexibility. For example, CCA reached 91% of our members and patients through virtual care by the end of 2020, allowing continuity of care for many individuals during a challenging and isolating time. Limitations, copayments, and restrictions may apply. They adhere to standards adopted by national accreditation organizations such as the National Committee for Quality Assurance (NCQA). Currently, this involves connecting members to federally funded free phones or internet connectivity services. Learn More About Your CCA Senior Care Options Plan, Health news, stories of care, and other information to help you live safely and independently at home, Here you will find information to help you get the most from your, 2022 COVID-19 Treatment Options and Guidelines, CCA Living Well at Home Magazine Massachusetts: Fall 2022. Welcome to your CCA MassHealth plan - Commonwealth Care Alliance MA April to September, 8 am 8 pm, Monday Friday, coverage determination or organization determination, Standard Pre-service Appeal: Answered within 30 days, Standard Post-service Appeal: Answered within 60 days. Commonwealth Care Alliance, a Boston health insurance company that last fall began an expansion outside Massachusetts, said Tuesday it is joining with a California nonprofit to launch a new entity . 2023 Boston Medical Center. Both have the same benefits package and it is only the network of doctors that are different for each plan. Without the need for transportation, it can be easier for patients and providers to come together on short notice or when the timing is ideal. Yes! We continuously track the number of members we serve through virtual care, the number of resulting virtual care visitsand how many of those are repeat members year over year. From March 2020 to December 2022, CCA conducted a total of 149,723 virtual care visits with 38,082 unique members. Serving more than 100,000 individuals across Massachusetts, Rhode Island, Michigan, and California, CCA delivers comprehensive, integrated, and person-centered care by coordinating the services of local staff, provider partners, and community organizations. MassHealth Accepted - MassHealth, CMSP, Limited, MGB ACO. What pharmacies can I use? Please describe these guidelines and why they're important for virtual care. When both Level 2 processes are engaged, the decision most favorable to the member applies. In 2022, the member video visit support team aided 2,898 members, either through a successful practice video visit, where our team would facilitate a call ahead of the members appointment to answer questions and ensure comfort and readiness, or to troubleshoot challenges in the moment if any arise. 2023 Medicaid Redetermination: What to expect? We also found members accessed our member video visit support team twice as frequently in 2022, compared to 2021, indicating more individuals are seeking the resources they need. Search from our 30,244 In-network providers, 5,506 primary care providers A Decrease font size. It's important to have health insurance at all times, so that your medical appointments, prescriptions, and lab tests are covered. 8{E-|$R s>1vH*,/0M>QFB2MtC=+Pe0Oo>7FsJVx{#" Click on the individual plan links to learn more about each one. To request a call, please fill out this form. HIMSS23 APAC unites thought leaders, disruptors and changemakers representing every sector across the health information and technology spectrum, creating a dynamic and thriving community that fosters the relationship between health and technology. CCA specializes in managing complex care for individuals dually eligible for Medicare and Medicaid, as well as those who narrowly miss the threshold for Medicaid.

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