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  If you need any of the following information in alternative formats or languages please contact us at 1-866-566-8989.  Administrative Error Impacting Access to Care STARLink advised the provider's office that the information was incorrect and asked them to continue seeing the child while the error was resolved. The provider agreed to see the child even though they already had 2 unpaid visits because they felt comfortable that STARLink would help get the issue resolved. STARLink enlisted the assistance of HHSC to get the information corrected. Within 6 days the information in the HHSC system was updated but not the claims system. STARLink continued following up until all information was corrected two weeks later, contacted the provider's office to inform them that they could now submit their claims. A pregnant woman had an appointment with her Ob-gyn for glucose tests but advised the client when they verified eligibility that they did not accept the plan she was enrolled with. Due to an error the client was changed from Parkland to Amerigroup and while the Ob-gyn's office insisted the tests should not wait until the following month, they refused to see the client while assigned to Amerigroup due to prior bad experiences in getting claims paid. STARLink contacted HHSC to request an immediate disenrollment from Amerigroup. By the time the client went to her appointment the following week she was back on Parkland and obtained the needed tests without delay.
Access to Long Term Care Services STARLink contacted HHSC, emphasized the urgency of the situation and the fact that client had been institutionalized for 5 months already. HHSC forced the disenrollment through the same day and the client got the pain pump refilled. The disenrollment was back dated to the date of nursing home admission and as a result the nursing home was able to file claims.
System Interface problems preventing access to care STARLink was able to confirm that she was covered but the information just wasn't updating to the claims system. After talking with the provider's office to facilitate immediate access to services STARLink enlisted the assistance of HHSC and within 4 days the client's eligibility information was updated to all systems.
Access to Transportation STARLink enlisted the assistance of the MTP regional supervisor who scheduled the ride.
Access to Prescriptions STARLink contacted the Vendor Drug Program for ideas. The Regional Pharmacist suggested that the pharmacy reverse the last Rx she got filled, which was a cheap generic, so that the more expensive drug could be paid for by Medicaid. STARLink contacted the Walmart pharmacy who was willing to do the transaction. The client paid for the generic and got the expensive Rx filled that day. After discussing the pros and cons of the HIPP program the client decided to disenroll from it so she could remain on STAR and get the unlimited Rx benefit. Due to the urgent nature of her health condition and need for prescriptions STARLink requested that HHSC expedite her re-enrollment into STAR. The client had initially called STARLink on February 22, 2006 and she was re-enrolled in STAR by March 1, 2006.
Children's Medicaid/CHIP Application
STARLink followed up with the Texas Access Alliance and was informed that the other child was Medicaid eligible but his file had not been sent to the Medicaid unit until the day of STARLink's inquiry. The child's Medicaid case was certified on 2/3/06 and coverage back dated to 11/1/05, the original date the child should have had coverage. Due to the long delay, by the time the child finally got coverage it was already time to begin the renewal process. Home | Clients | Providers | Contact Us | Sign Up |
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