Departmental Wards/Xxxxxx Care Clients Sample Clauses

Departmental Wards/Xxxxxx Care Clients. The EBS shall coordinate enrollment activities with the Department’s Protection and Safety (PS) worker responsible for the case management of the xxxx/xxxxxx child. The PS worker shall work with the client and the client’s family or legal representative, as appropriate, to complete the health assessment and explore the most appropriate choice of PCP/plan. The PS Worker shall notify the EBS of the client’s choice at the time the health assessment is completed. The EBS shall work with the PS Worker to outreach to the Department Xxxx/Xxxxxx Care client who are mandatory for NHC with letters and telephone contacts (as appropriate, depending upon the needs of the client), according to standard enrollment activities. A Department Xxxx/Xxxxxx care client will be excluded from auto-assignment. After completing the full enrollment process, the EBS shall make one last outreach attempt by sending the client a “ pre-nomination” letter identifying a potential PCP/plan based on information known about the client on the eligibility and claims history file. The client shall have an additional fifteen (15) calendar days from the date of the pre-nomination letter to make a change in the proposed PCP/plan. If the client does not make a change, the EBS shall activate the enrollment. In some cases, the EBS may delay the activation of the client’s enrollment for an additional thirty (30) day period to allow the EBS to coordinate necessary services with the prospective PCP/plan. If the EBS determines that the client does not have any medical issues that need immediate attention by the PCP/plan, the enrollment may be “ activated” immediately following completion of the enrollment activities described above. The EBS shall be responsible for tracking the extended activation period, and reporting such activity to the Department. The EBS shall complete the enrollment activities by entering the information on the Managed Care File, and contacting the PCP/plan, to alert them to any immediate medical or social issues.
Sample 1
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