Advise the caller of their open enrollment dates and end the call.
Create a supervisor task and include the PCP name and explain the situation.
Submit request to process the plan change using GC4 because the provider is no longer able to provide effective care.
Submit request to process the plan change using GC8 because the caller is unable to access the provider.
Advise the caller, the provider knows what is best for her and she should stick with the plan so they can continue to help her.
The grievance is a formal complaint filed by the recipient with the plan concerning issues.
The grievance is a formal complaint made by the plan against the recipient for complaining.
The grievance is when the recipient calls AHS and complains about the plan.
The grievance is a court setting in which the member, health plan, and AHCA meet.
Process the plan change with GC1 to Humana Medical Plan with the new provider, Dr. Flan.
Advise the caller that the information does not qualify for a plan change, verify if there is another reason the caller would like to change the plan, if not, advise caller of next open enrollment period.
Process request with GC9.
Process request with GC1610, and document in the notes that the caller does not want the original provider.
Advise the caller to contact the plan so they can resolve the issue.
Process plan change request with GC1624.
Process plan change request with GC3.
Advise the caller that they do not qualify to change their plan because they selected to be in that plan and they will have to wait until the next open enrollment.