Tell the caller to fax the letter so it can be sent to AHCA for verification.
Tell the caller they have to wait until open enrollment to change.
Refer the caller to the health plan to request a new doctor.
Tell the caller to get an out of network authorization.
Tell the caller they must complete the grievance process first, before the Good Cause can be submitted to AHCA.
Tell the caller they must wait until open enrollment to change the health plan.
Refer the caller to the Area Medicaid Office for an exemption.
For extreme circumstances, submit a supervisor task to verify if the SNU needs to review the issue. In the meantime, advise the caller to contact the plan case manager.
Look in FMMIS.
Ask the caller if they picked the plan or not.
Look in HealthTrack History.
Just answer "yes" to the question, so that the GC9 can be submitted.
Submit a request for GC4 because the specialist is not providing effective care and this good cause gets approved by AHCA. AHCA will ensure the provider does not reschedule anymore appointments and the good cause gets approved.
Call a supervisor/lead for approval to use a GC1610, because you can see the request was placed and just did not process, and GC1610 can be approved by AHS.
Advise the caller to speak with the specialist about their ineffective treatment.
Process the request with GC1621, because the provider is delaying treatment and denying proper services.