NOTICE

The best way to protect yourself against EBT theft is to call 1-888-328-2666 to change your PIN number before the start of each month.

Starting May 22, the Manchester Resource Center will reopen at 699 Middle Turnpike E., Manchester.  

HBPO RFP 07022019 SECTION V - APPENDICES

Overview

Appendix A - Statement of Work

Appendix A - Statement of Work 

 

Appendix B - Sample List of Special Projects

Appendix B - Sample List of Special Projects 

 

Appendix C - Process and Procedure Guides

Appendix C - Paper Renewal Data Entry PP Guide V1.1 

Appendix C -Paper Verification Processing PP Guide V1.8 

Appendix C -Premium Billing Exception Support PP Guide V1.0 

Appendix C -Spend-Down Expense Support PP Guide V1.0 

Appendix C -Administration Of Unknown Items PP Guide V1.0  

Appendix C -Data Entry of HUSKY-C and MSP Referrals PP Guide V1.1 

Appendix C -EMPI Administration PP Guide V2.0 

Appendix C -Handling Returned Missing Information PP Guide V1.2 

Appendix C -Hearing Appeals Support PP Guide V2.0 

Appendix C -MAGI Case Maintenance Support PP Guide V1.3 

Appendix C -Paper Application Data Entry PP Guide V1.2 

 

Appendix D - Quality Assurance Plan for Health Outsourcing

Appendix D - Quality Assurance Plan for Health Outsourcing 

 

Appendix E - Daily Report - 2019-01-02

Appendix E - Daily Report 2019-01-02 

 

Appendix F - Weekly Dashboard - 2019-01-17

Appendix F-Weekly Dashboard 2019-01-17 

 

Appendix G - HUSKY Health Business Analytics Dashboard - 2018-12

Appendix G - HUSKY Health Business Analytics Dashboard-2018-12 

 

Appendix H - Quality Assurance Dashboard - 2018-12

Appendix H - Quality Assurance Dashboard-2018-12 

 

Appendix I - Scan Optics Daily Report - 2018-08-27

Appendix I - Scan Optics Daily Report - 2019-01-18 

 

Appendix J - AH1, AH2 and AH3 Application Forms

Appendix J - AH1 Application Form 

Appendix J - AH2 Application Form 

Appendix J - AH3 Application Form 

 

Appendix K - AH3-R Renewal Form – Template

Appendix K - AH3-R Renewal Form - BW Template 

 

Appendix L - HIX/Tier-1 Worker Portal Screenshots

Appendix L -READ-ME     

Appendix L -1M-113-HIX-Tier-1WorkerPortalIntroduction 

Appendix L -T1M-116-HIX-Tier-1TakingAnApplication 

Appendix L -T1M-118-HIX-Tier-1ApplicationQuickLinks 

Appendix L -T1WM-101-HIX-Tier-1WorkflowScreens 

 

Appendix M - ImpaCT Screenshots

Appendix M - ImpaCT Screenshots 

 

Appendix N - HIX/Tier-1 FileNet Document Ingestion Report - 2019-01-20

Appendix N - HIXTier-1 File Net Document Ingestion Report - 2019-01-20 

 

Appendix O - HIX/Tier-1 System Demonstration

Application 

Manage VCL Processing  

 

Appendix P - Cost Budget Template

Appendix P - Cost Budget Template 

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