REQUIRED MEMBER INFORMATION. 4.2.1 Within five (5) business days following receipt of the enrollment file from DHS, the PASSE must mail to each newly enrolled member a welcome packet that contains a member identification (ID) card, a member handbook, and instructions for how to access the PASSE’s provider directory, including language specific for how a member can request a paper form of the provider directory.
4.2.2 Member ID Card—The Member ID card must include, at a minimum:
a. The member’s name, and member’s unique identification number, as established by the PASSE;
b. The PASSE’s name, address and member helpline number;
c. A telephone number that a provider may call for billing information; and
d. The DHS provided logo on the front of the member ID card. Replacement Member ID cards must be made available at the enrolled member’s request.
REQUIRED MEMBER INFORMATION. 4.2.1 Within five (5) business days following receipt of the enrollment file from DHS, the PASSE must mail to each newly Enrolled Member a welcome packet that contains a member identification (ID) card, a member handbook, and instructions for how to access the PASSE’s provider directory, including language specific for how a member can request a paper form of the provider directory.
4.2.2 Member ID Card—The Member ID card must include, at a minimum:
a. The member’s name, and member’s unique identification number, as established by the PASSE;
b. The PASSE’s name, address and member helpline number;
c. A telephone number that a provider may call for billing information; and
d. The DHS provided logo on the front of the member ID card.
e. Replacement Member ID cards must be made available at the Enrolled Member’s request, without cost to the member.
4.2.3 Member Handbook—The Member Handbook must meet the requirements set forth in 42 CFR § 438.10 and include, at a minimum:
a. A Table of Contents;
b. The terms, conditions, and procedures for enrollment, including reinstatement;
c. The member’s rights and responsibilities, as described in Section 4.6;
d. How to access information in accessible formats as described in Section 4.1.3;
e. The toll-free telephone numbers for member services, medical management and Care Coordination, and for any other unit that provides services directly to Enrolled Members;
f. The member’s rights to transition to a different PASSE, the procedures for filing a request for transition, and the following language verbatim, in bold or large font:
g. A description of services provided by the PASSE in sufficient detail to ensure that Enrolled Members understand the services that may be available to them, including:
i. Care Coordination and the development of the PCSP;
ii. Home and Community Based Services (HCBS); and
iii. The availability of emergency services under the PASSE, including (1) how emergency services are provided, (2) the definition of what constitutes an emergency medical condition and the definition of what constitutes an emergency medical service, (3) that prior authorizations are not required for emergency medical services, and (4) that an Enrolled Member may use any hospital or other setting for emergency care, regardless of whether it is a participating or Out-of-Network Provider.
h. The process for selecting and changing the member’s PCP;
i. Any limitations and general restrictions on provider access, exclusions, and use ...
REQUIRED MEMBER INFORMATION. Chapter shall provide to CREW Network the following information for each member: full name, company, title, address (including city, state/province, postal code), email address, approved membership category, years of experience in commercial real estate, and qualified field of commercial real estate (QFCRE) as determined by chapter leaders using CREW Network’s defined qualified fields of commercial real estate as a guideline.
