|
|
Removal of OHC Codes for Victims of Domestic Violence
When MC benefits are used, the OHC policyholder will be provided an Explanation of Benefits which indicates where and when the benefits were used. This can be an issue when victims of domestic abuse flee the home and need to utilize the services of an OHC policy held by the abuser. The EW must remove the OHC code from MEDS to ensure the safety of the victims when they are made aware of the situation.
Written verification to support the domestic violence claim is not necessary. However, the EW must document the reason for the OHC removal in the Journal Detail Page in CalSAWS.
Related Topics
Overview of the Managed Care Two-Plan Model
Health Care Options Enrollment Contractor
Managed Care for Mental Health Services
Coordinated Care Initiative - Cal MediConnect
Health Insurance Premium Payment (HIPP) Program
OHC for Foster Care/Adoption Assistance Children
Repayment for Medical Services