Newsroom > DHHS News Release
For Immediate Release
May 9, 2016
Contact Julie Naughton, Communications and Legislative Services, (office) 402-471-1695 or (cell) 402-405-7202, firstname.lastname@example.org
State of Nebraska Signs Contract for Enrollment Broker Services with Automated Health Systems, Inc.
AHS to serve as link between the managed care delivery system and Nebraska Medicaid members
Lincoln— The Department of Health and Human Services has executed its contract for its Medicaid enrollment broker services to Automated Health Systems, Inc (AHS).
AHS will serve as the link between Heritage Health, the state’s new integrated managed care delivery system, and Nebraska Medicaid members in providing unbiased outreach, enrollment and education services to approximately 231,000 Medicaid members. Starting in September, AHS will begin assisting Medicaid enrollees in choosing from among the three Heritage Health plans and selecting a primary care provider (PCP). Heritage Health plans include Nebraska Total Care, United Healthcare of the Midlands, and Wellcare of Nebraska. Coverage under the Heritage Health program begins on January 1, 2017. For more information about Heritage Health, visit dhhs.ne.gov/HeritageHealth.
“AHS will be a valuable partner to Nebraska Medicaid as we implement Heritage Health, providing information and assistance to our state’s Medicaid enrollees to help more individuals proactively select the health plan that best suits their families’ needs,” said Calder Lynch, director of the state’s Division of Medicaid and Long-Term Care.
As the enrollment broker, AHS will provide the following services for the Medicaid program:
AHS will assist Nebraska Medicaid members with enrollment in their desired Heritage Health plan and selection of their Primary Care Provider (PCP) through web portal, call center or mail.
AHS will maintain a website for member use that will provide members with information to aid in selecting a health plan and PCP. The website will also include search capabilities for members to locate a provider by specified distance from their location, such as searching by street address, county or zip code.
AHS will operate a member call center as well as real-time chat to respond to questions and concerns regarding Heritage Health managed care, health plan enrollment and PCP selection.
Written information will be provided to the member to assist in the enrollment process. Examples include explanation about the enrollment process, an informational brochure about Heritage Health, information on each health plan, the importance of selecting a PCP, enrollment broker contact information and a calendar with appropriate dates for selecting a health plan and PCP.
AHS will maintain a provider directory available to all Medicaid members. The provider directory will provide names, locations, telephone numbers, specialties and list the non-English languages spoken by all current contracted providers in each health plan’s network. The provider directory will be available to members in both a hard copy format and a web-based searchable format.
AHS will support the enrollment of Medicaid members in the Program for All-Inclusive Care for the Elderly (PACE). The PACE program provides long-term care services and supports to enable participants to continue to live in their homes and communities.
On or before January 2018, AHS will also work with DHHS to determine the monthly capitation payment each MCO should receive and calculate any needed payment recoupments.
AHS was founded in 1979 and is headquartered in Pittsburgh, Pennsylvania. AHS has 37 years of experience in providing Medicaid assistance services to enrollees, including 20 years of consecutive experience as an enrollment broker in five states, and 30 years of experience managing call center operations for Medicaid services. AHS currently operates enrollment brokering services in Florida, Ohio, Wisconsin and West Virginia, and also has successfully implemented enrollment brokering services in Illinois.
“AHS has an excellent reputation of working with community-based organizations, multiple state agencies, providers, and advocacy groups in support of beneficiaries receiving timely, unbiased and accurate plan information during their selection of a Medicaid health plan,” said Dr. Moses Haregewoyn, president of AHS. “We are acutely aware of the importance of effective and culturally sensitive training so each beneficiary is approached with dignity and accurate information relating to their individual and family needs.”