New Enrollee Orientation. The Contractor shall offer culturally appropriate orientation sessions for new Enrollees conducted in, at a minimum, Spanish, English, Vietnamese, Chinese and American Sign Language as appropriate to the audience. Orientation sessions can be either in a group setting or in individual meetings and shall, at a minimum, cover the following topics:
New Enrollee Orientation. The CHIP-MCO must have written policies and procedures for new Enrollees or a written orientation plan or program that includes: ● Orienting new Enrollees to their benefits (e.g., prenatal care, dental care, and specialty care); ● Educational and preventative care programs that include an emphasis on health promotion, wellness and healthy lifestyles and practices; ● Education of members on how they can report suspected fraud, waste, and abuse; ● The proper use of the CHIP-MCO identification card; ● The role of the PCP; ● What to do in an emergency or urgent medical situation; ● How to utilize services in other circumstances, ● How to request information from the CHIP-MCO; ● How to register a Complaint, file a Grievance, request an external review, or request a DHS Fair Hearing. The CHIP-MCO must obtain the Department advance written approval of these policies and procedures. The CHIP-MCO is prohibited from contacting a potential Enrollee who is identified on the Daily Membership File with an automatic assignment indicator (either an "A" auto- assigned or "M" Member/ Enrollee assigned) until five (5) Business Days before the effective date of the Enrollee’s Enrollment unless it is the CHIP- MCO’s responsibility under this Agreement; or at the request of the Department.
