Pascal Bergeron
Latest posts by Pascal Bergeron (see all)

Scenario:

You have a new potential resident and you are reviewing their financials to determine if you want to accept them into your ALF. You have been informed that the prospect has full Medicaid and you want to make sure you will be able to bill for ACS “Assistive Care Services”.

You go to the Florida Medicaid portal website and check their eligibility. The individual is showing as having full medicaid but you do not recognize the MMA plan that is assigned to them as one that is contracted with your facility.

 

Reasons For This

The individual has an address on file with Social Security or DCF that is outside of your designated region and therefore has a plan from their home region.

Look below to find out your region and which plans are offered in your region.

In order to change the individual’s plan, I recommend that you contact Social Security and DCF and change the individual’s address to the facility’s address.  Once this is done, give it a few days to reflect in the Mediciad system and then go to http://www.flmedicaidmanagedcare.com/. You should now be able to select a new MMA plan that your facility is contracted within your region. If you are unable on the website try calling 1-877-711-3662 and speak with a counselor.

Bad News

You can expect to lose a month of Assistive Care Services Reimbursement when dealing with a case like this, which means it will take about two months before you receive any money from medicaid for that resident. Your facility will lose the month’s reimbursement for the month they were effective with the old plan, since the new plan will not go into effect until the following month. Keep that in mind when you are doing your evaluation of the resident.

 

regionplans

 

  • 44
  • 70
  • 22
  •  
    136
    Shares