Service Tree

Medicaid Appeals/Complaints

Programs that are responsible for hearing appeals and resolving complaints that have been filed by people who have applied for or who are receiving services through Medicaid and believe that they have been discriminated against, that their rights have been violated or that the state or county has failed to take appropriate action with respect to their application or benefits.

• Service code: NL-5000.5000-500
• 1 provider

Medicaid Applications

County or state offices that accept applications and determine eligibility for the Medicaid program; and reinstate individuals who have lost their Medicaid benefits due to incarceration, institutionalization, noncompliance or other reasons. Also included are other programs that help people prepare and file Medicaid applications and/or are authorized to do eligibility determinations for the program.

• Service code: NL-5000.5000-520
• 5 providers

State Medicaid Managed Care Insurance Carriers

Private insurance companies that issue managed care policies to people who qualify under Medicaid, generally on the basis of a contractual arrangement with the state. Enrollment in a managed care plan may be voluntary or mandatory for some or all Medicaid recipients in a state; and participation requirements and associated criteria vary from state to state and in some cases, from area to area within the same state. Benefits covered by Medicaid vary by jurisdiction but generally include hospitalization, physician services, emergency room visits, family planning, immunizations, laboratory and x-ray services, outpatient surgery, chiropractic care, prescriptions, eye exams, eye glasses and dental care. Other covered services may include alcohol and drug treatment, mental health services, medical equipment and supplies and rehabilitative therapy. Medical benefits are administered by the insurance companies under terms of their contract.

• Service code: NL-5000.5000-775
• 2 providers