Medicaid CA | Baamboozle - Baamboozle | The Most Fun Classroom Games!

English 10 Public

member services

Study Slideshow

what is the TAT for a standard CA Medicaid grievance?

5 days to acknowledge 30 days to resolve

15

What is the timeframe a member has to file a expedited Appeal?

60 calendar days from date Auth was denied

20

What does AVES stand for

Automated Eligibility Verification System

15

What is CA Medicaid also known as?

Medi-Cal

10

What does IPA stand for?

Independent Practice Association

10

what services are IPA groups responsible for?

All professional services a member receives

5

What is considered a Facility service?

Hospital, Pharmacy, or skilled nursing facility

25

If a member calls in to change PCP on June 12th and has accessed care what will you choose for effective date

you would not change it you would reach out to the lead line

20

when assisting member with scheduling an appointment when should a second opinion appointment be scheduled?

within 30 calendar days of the request

15

where would you go to look up a CPT code to see if it needs a PA

custom links, or Molinahealthcare.com

10