Common use of Education Activities Clause in Contracts

Education Activities. Contractor shall be responsible for educating enrollees and other interested individuals (and Customer Support Representatives) regarding program policies and benefits. Educational activities may be conducted via mail, by telephone and through in-person meetings at the Green Mountain Care Member Services office (walk-ins). Contractor shall provide information and assist enrollees (and Customer Support Representatives) in understanding all facets of the State's health care programs, including the following: ⮚ General concepts about Medicaid, Dr. Dynasaur, VHAP and of health care delivery in a managed care model, until any such programs are retired. ⮚ How to access services under all State health care programs. ⮚ Services covered by the different health care programs offered by the State, to include services that are not covered. ⮚ General concept of the Dental Home initiative and help locate a dental provider. ⮚ The role and responsibilities of the Primary Care Provider (PCP). ⮚ The importance of selecting a health plan and a Primary Care Provider. ⮚ Beneficiary rights, including appeal and fair hearing rights, confidentiality rights and availability of the Office of the Healthcare Advocate. ⮚ Beneficiary responsibilities, including necessity of obtaining prior authorization and proper utilization of emergency services. ⮚ Cost sharing (program premiums, co-payments, etc.) responsibilities. ⮚ Responsibilities of the plan member to follow health plan procedures for seeking emergency and non-emergency services; making, keeping, canceling appointments with PCP/specialists; seeking hospital admissions; and circumstances in which self-referral is appropriate. ⮚ Information about the Automatic Assignment Process for Plans and PCP's. ⮚ General information about the Bus Voucher Program, including eligibility, guidelines, and exceptions. ⮚ All functions associated with using the HBE web portal to determine QHP eligibility, enroll, accept credit/debit card payments in a PCI compliant workplace, and provide customer service related to premium processing for Exchange customers including but not limited to the same services provided to customers of public healthcare programs. ⮚ Educate callers regarding the policy of Advanced Premium Tax Credits and Cost sharing subsidies. ⮚ Educate customers and respond to questions to assist consumers with the QHP application process. Assists customers in understanding application questions so the accuracy of customer responses are optimized. In addition to education activities at the time of enrollment, Contractor shall continue to provide assistance to enrollees throughout the contract regarding program benefits, policies and procedures. Contractor shall assist participants in understanding and resolving initial enrollment problems that may arise with regard to health plan policies or their Primary Care Provider (PCP), or refer to the QHP as appropriate. Contractor shall staff a toll-free line to assist enrollees and other interested individuals in understanding program benefits and policies and to respond to questions. Eligible individuals should have the ability to pick a health plan, a PCP, a CHAP or the Exchange Qualified Health (QHP) plan and dental home provider over the telephone.

Education Activities. Contractor shall be responsible for educating enrollees and other interested individuals (and Customer Support Representatives) regarding program policies and benefits. Educational activities may be conducted via mail, by telephone and through in-person meetings at the Green Mountain Care Member Services office (walk-ins). Contractor shall provide information and assist enrollees (and Customer Support Representatives) in understanding all facets of the State's health care programs, including the following: ⮚  General concepts about Medicaid, Dr. Dynasaur, VHAP and of health care delivery in a managed care model, until any such programs are retired. ⮚  How to access services under all State health care programs. ⮚  Services covered by the different health care programs offered by the State, to include services that are not covered. ⮚  General concept of the Dental Home initiative and help locate a dental provider. ⮚  The role and responsibilities of the Primary Care Provider (PCP). ⮚  The importance of selecting a health plan and a Primary Care Provider. ⮚  Beneficiary rights, including appeal and fair hearing rights, confidentiality rights and availability of the Office of the Healthcare Advocate. ⮚  Beneficiary responsibilities, including necessity of obtaining prior authorization and proper utilization of emergency services. ⮚  Cost sharing (program premiums, co-payments, etc.) responsibilities. ⮚  Responsibilities of the plan member to follow health plan procedures for seeking emergency and non-emergency services; making, keeping, canceling appointments with PCP/specialists; seeking hospital admissions; and circumstances in which self-self- referral is appropriate. ⮚  Information about the Automatic Assignment Process for Plans and PCP's. ⮚  General information about the Bus Voucher Program, including eligibility, guidelines, and exceptions. ⮚  All functions associated with using the HBE web portal to determine QHP eligibility, enroll, accept credit/debit card payments in a PCI compliant workplace, and provide customer service related to premium processing for Exchange customers including but not limited to the same services provided to customers of public healthcare programs. ⮚  Educate callers regarding the policy of Advanced Premium Tax Credits and Cost sharing subsidies. ⮚  Educate customers and respond to questions to assist consumers with the QHP application process. Assists customers in understanding application questions so the accuracy of customer responses are optimized. In addition to education activities at the time of enrollment, Contractor shall continue to provide assistance to enrollees throughout the contract regarding program benefits, policies and procedures. Contractor shall assist participants in understanding and resolving initial enrollment problems that may arise with regard to health plan policies or their Primary Care Provider (PCP), or refer to the QHP as appropriate. Contractor shall staff a toll-free line to assist enrollees and other interested individuals in understanding program benefits and policies and to respond to questions. Eligible individuals should have the ability to pick a health plan, a PCP, a CHAP or the Exchange Qualified Health (QHP) plan and dental home provider over the telephone.

Education Activities. Contractor shall be responsible for educating enrollees and other interested individuals (and Customer Support Representatives) regarding program policies and benefits. Educational activities may be conducted via mail, by telephone and through in-person meetings at the Green Mountain Care Member Services office (walk-ins). Contractor shall provide information and assist enrollees (and Customer Support Representatives) in understanding all facets of the State's health care programs, including the following: ⮚  General concepts about Medicaid, Dr. Dynasaur, VHAP and of health care delivery in a managed care model, until any such programs are retired. ⮚  How to access services under all State health care programs. ⮚  Services covered by the different health care programs offered by the State, to include services that are not covered. ⮚  General concept of the Dental Home initiative and help locate a dental provider. ⮚  The role and responsibilities of the Primary Care Provider (PCP). ⮚  The importance of selecting a health plan and a Primary Care Provider. ⮚  Beneficiary rights, including appeal and fair hearing rights, confidentiality rights and availability of the Office of the Healthcare Advocate. ⮚  Beneficiary responsibilities, including necessity of obtaining prior authorization and proper utilization of emergency services. ⮚  Cost sharing (program premiums, co-payments, etc.) responsibilities. ⮚  Responsibilities of the plan member to follow health plan procedures for seeking emergency and non-emergency services; making, keeping, canceling appointments with PCP/specialists; seeking hospital admissions; and circumstances in which self-referral is appropriate. ⮚  Information about the Automatic Assignment Process for Plans and PCP's. ⮚  General information about the Bus Voucher Program, including eligibility, guidelines, and exceptions. ⮚  All functions associated with using the HBE web portal to determine QHP eligibility, enroll, accept credit/debit card payments in a PCI compliant workplace, and provide customer service related to premium processing for Exchange customers including but not limited to the same services provided to customers of public healthcare programs. ⮚  Educate callers regarding the policy of Advanced Premium Tax Credits and Cost sharing subsidies. ⮚  Educate customers and respond to questions to assist consumers with the QHP application process. Assists customers in understanding application questions so the accuracy of customer responses are optimized. In addition to education activities at the time of enrollment, Contractor shall continue to provide assistance to enrollees throughout the contract regarding program benefits, policies and procedures. Contractor shall assist participants in understanding and resolving initial enrollment problems that may arise with regard to health plan policies or their Primary Care Provider (PCP), or refer to the QHP as appropriate. Contractor shall staff a toll-free line to assist enrollees and other interested individuals in understanding program benefits and policies and to respond to questions. Eligible individuals should have the ability to pick a health plan, a PCP, a CHAP or the Exchange Qualified Health (QHP) plan and dental home provider over the telephone.

Education Activities. Contractor shall be responsible for educating enrollees and other interested individuals (and Customer Support Representatives) regarding program policies and benefits. Educational activities may be conducted via mail, by telephone and through in-person meetings at the Green Mountain Care Member Services office (walk-ins). Contractor shall provide information and assist enrollees (and Customer Support Representatives) in understanding all facets of the State's health care programs, including the following: ⮚ General concepts about Medicaid, Dr. DynasaurXxxxxxxx, VHAP and of health care delivery in a managed care model, until any such programs are retired. ⮚ How to access services under all State health care programs. ⮚ Services covered by the different health care programs offered by the State, to include services that are not covered. ⮚ General concept of the Dental Home initiative and help locate a dental provider. ⮚ The role and responsibilities of the Primary Care Provider (PCP). ⮚ The importance of selecting a health plan and a Primary Care Provider. ⮚ Beneficiary rights, including appeal and fair hearing rights, confidentiality rights and availability of the Office of the Healthcare Advocate. ⮚ Beneficiary responsibilities, including necessity of obtaining prior authorization and proper utilization of emergency services. ⮚ Cost sharing (program premiums, co-payments, etc.) responsibilities. ⮚ Responsibilities of the plan member to follow health plan procedures for seeking emergency and non-emergency services; making, keeping, canceling appointments with PCP/specialists; seeking hospital admissions; and circumstances in which self-self- referral is appropriate. ⮚ Information about the Automatic Assignment Process for Plans and PCP's. ⮚ General information about the Bus Voucher Program, including eligibility, guidelines, and exceptions. ⮚ All functions associated with using the HBE web portal to determine QHP eligibility, enroll, accept credit/debit card payments in a PCI compliant workplace, and provide customer service related to premium processing for Exchange customers including but not limited to the same services provided to customers of public healthcare programs. ⮚ Educate callers regarding the policy of Advanced Premium Tax Credits and Cost sharing subsidies. ⮚ Educate customers and respond to questions to assist consumers with the QHP application process. Assists customers in understanding application questions so the accuracy of customer responses are optimized. In addition to education activities at the time of enrollment, Contractor shall continue to provide assistance to enrollees throughout the contract regarding program benefits, policies and procedures. Contractor shall assist participants in understanding and resolving initial enrollment problems that may arise with regard to health plan policies or their Primary Care Provider (PCP), or refer to the QHP as appropriate. Contractor shall staff a toll-free line to assist enrollees and other interested individuals in understanding program benefits and policies and to respond to questions. Eligible individuals should have the ability to pick a health plan, a PCP, a CHAP or the Exchange Qualified Health (QHP) plan and dental home provider over the telephone.