Written policies and Yes Title V 0 None procedures are in place 1 Weak (IF YES) How effective are those State Medicaid allowing CYSHCN who are policies and procedures? CHIP 2 Moderate newly enrolled or have 1 Not effective Health Plan/Insurer 3 Strong recently changed health 2 Somewhat effective Provider (please specify) plans to continue seeing 3 Very effective Family/Consumer providers, for up Other (please specify) to six months after enrollment. OPTIONAL: Why? No for score, above ) (Select “0” Not applicable to my organization Enter Score: Enter Score: A comprehensive member Yes Title V 0 None services program with (IF YES) How effective are those State Medicaid 1 Weak specialized staff and policies and procedures? CHIP 2 Moderate linkages to relevant family 1 Not effective Health Plan/Insurer 3 Strong organizations at the state 2 Somewhat effective Provider (please specify) and local level is available to 3 Very effective Family/Consumer provide information and Other (please specify) assistance to CYSHCN and their families in areas OPTIONAL: including: family resource Why? needs, insurance coverage No for score, above) (Select “0” options, eligibility and Not applicable to my organization enrollment questions, covered and non-covered services, navigating the medical and community system of care available for CYSHCN, enrollee status, complaints and grievances, and selection of a primary Enter Score: Enter Score: care provider or other such medical home with experience in serving CYSHCN.
Written policies and procedures are in place allowing CYSHCN who are newly enrolled or have recently changed health plans to continue seeing providers, for up to six months after enrollment. Yes (IF YES) How effective are those policies and procedures? 1 Not effective 2 Somewhat effective 3 Very effective No (Select “0” for score, above ) Not applicable to my organization Enter Score: Title V State Medicaid CHIP Health Plan/Insurer Provider (please specify) Family/Consumer Other (please specify) 0 None 1 Weak 2 Moderate 3 Strong OPTIONAL: Why? Enter Score: A comprehensive member services program with specialized staff and linkages to relevant family organizations at the state and local level is available to provide information and assistance to CYSHCN and their families in areas including: family resource needs, insurance coverage options, eligibility and enrollment questions, covered and non-covered services, navigating the medical and community system of care available for CYSHCN, enrollee status, complaints and grievances, and selection of a primary care provider or other such medical home with experience in serving CYSHCN. Yes (IF YES) How effective are those policies and procedures? 1 Not effective 2 Somewhat effective 3 Very effective No (Select “0” for score, above) Not applicable to my organization Enter Score: Title V State Medicaid CHIP Health Plan/Insurer Provider (please specify) Family/Consumer Other (please specify) 0 None 1 Weak 2 Moderate 3 Strong OPTIONAL: Why? Enter Score:
2_Eligibility%20and%20Enrollment_In%20DepthFINAL.docx