Help dual enrolled members complete the annual recertification process
Each year, in order for members to retain their Medicaid status, they must complete the recertification process in accordance with their state’s Medicaid policy. With RECERT Complete™, Altegra Health acts on health plan members’ behalf by helping to ensure they do not miss the annual deadline and advocate on their behalf to re-enroll into these important programs.
Existing dual enrollment in both the Medicare and Medicaid programs (including Medicare Savings Programs) is a prerequisite for joining a dual eligible Special Needs Plan (SNP). Thereafter, SNP members need to retain their dual enrollment status by completing the annual redetermination or recertification process administered by their state’s Medicaid administration. Altegra Health’s RECERT Complete service helps dual enrolled MA members, who became dual enrolled on their own or through a third-party advocate other than Altegra Health, to complete the annual recertification process.
- Recertification Correspondence – Send reminder notifications to dual enrolled members in 90-, 60-, and 30-day increments in advance of the annual expiration date of their current Medicaid coverage period, prompting them to also gain guidance on completing the process with the help of an Altegra Health advocate or on their own.
- Follow-up Phone Calls – Prompt dual enrolled members to complete the recertification on their own or call Altegra Health for assistance in completing the required paperwork as soon as members are close to the renewal date of their current Medicaid enrollment period.
- Form Completion Assistance – Assist dual enrolled members who with the form process Altegra Health’s advocates, who will assist in gathering and submitting the applicable verifications according to updated income and asset verifications required by the state’s Medicaid administration.
- Resolve Any Eligibility Disputes – Help members resolve disputes that might otherwise result in a member’s recertification application being denied.
- Monitoring Monthly Membership Reports (MMRs) – Have Altegra Health monitor the MMRs from the Centers for Medicare & Medicaid Services to ensure that members’ ongoing Medicaid status is reflected accurately.