HMS offers eligibility and enrollment services for CHIPs, coupled with a full service customer call center to answer enrollee questions, resolve program issues, and provide excellent customer support during the application and coverage period. Standard to our approach is an exhaustive search for other coverage available to CHIP applicants, which helps the program abide by federal rules that prohibit CHIP benefits being extended to children who have other coverage.
HMS’s services are all-encompassing, including application receipt and review, eligibility determination, enrollment processing, and continuous communication with program participants via our call center services. Other services include assisting the CHIP in its efforts to engage additional members through marketing and program outreach.
Our solution includes:
- Accepting and reviewing applications for completeness
- Resolving issues surrounding duplicate or incomplete applications
- Determining if an applicant meets eligibility requirements
- Handling appeals
- Coordinating enrollment processes
- Managing premium payments and coordination
- Interfacing with contracted managed care plans and providers
- Answering applicant and other stakeholder questions
- Resolving program issues
- Initiating renewal procedures
- Creating and disseminating program marketing and application materials
We provide only verified policies to our clients. We supplement 270/271s with other verification processes, including through the Web and live person-to-person telephone contact. We perform over 350,000 voice verifications a month.
