Prospective Enrollee definition

Prospective Enrollee means any individual residing in the Contractor’s Service Area that has not yet enrolled in a MCO’s MMC or FHPlus product.

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Prospective Enrollee means any individual who is eligible for enrollment or reenrollment in a health plan.

Prospective Enrollee means any individual residing in the Contractor's Service Area that has not yet enrolled in a MCO's MMC or FHPlus product.

Examples of Prospective Enrollee in a sentence

The Care Coordinator assigned to the Prospective Enrollee shall attempt to contact the Prospective Enrollee no later than two (2) Business Days after the Care Coordinator is notified of the request for coordination of care.
A Prospective Enrollee shall become an Enrollee on the effective date of enrollment.
Once the Department has determined that a Participant is a Potential Enrollee, and after the Potential Enrollee has selected, or been auto-assigned to, Contractor, such Participant shall become a Prospective Enrollee.
Where the language is other than English, the Contractor shall offer and, if accepted by the Potential Enrollee, Prospective Enrollee or Enrollee, shall supply interpretive services.
For each DCFS Youth in Care Prospective Enrollee identified through the Department’s 834 Daily File, Contractor shall: conduct a health risk screening; score the health risk screening to identify medical and Behavioral Health care needs; stratify based on need for Care Coordination; establish the appropriate Care Coordination team and assign a primary Care Coordinator; and complete additional assessments as needed.

More Definitions of Prospective Enrollee

Prospective Enrollee means a Potential Enrollee who has begun the process of enrollment with the Contractor but whose coverage under the Plan has not yet begun.

Prospective Enrollee means any individual residing or working in the Contractor’s Service Area that has not yet enrolled in an HIV SNP.

Prospective Enrollee means an individual eligible for enrollment in a managed care plan offered by that individual's employer.

Prospective Enrollee means a Potential Enrollee who has begun the process of Enrollment with the Contractor but whose coverage under the Plan has not yet begun.

Prospective Enrollee means a Potential Enrollee who has begun the process of enrollment with Contractor but whose coverage with Contractor has not yet begun. Protected Health Information (PHI) shall have the same meaning as provided in HIPAA, 45 CFR 160.103, and for the purpose of this Contract shall be limited to the information received from the Department, or created, maintained, or received by Contractor on behalf of the Department, in connection with this Contract.

Prospective Enrollee means any Eligible Person as defined in this Agreement that has not yet enrolled in the Contractor's Medicaid Advantage Product.

Prospective Enrollee means any individual residing in the MMCO’s service