Question: If you are verifying eligibility for a patient in the new CoreMMIS Portal and you see “Medical Review Team” displayed under the Coverage section, what does that mean?
a) The patient is enrolled in Medicaid for the Disabled
b) The patient is being evaluated for IHCP eligibility
c) You need to call the Medical Review Team
d) CoreMMIS is having issues, I don’t need to worry about it.
Answer: While you may be tempted to go with answer “d,” what you should conclude from the “Medical Review Team” note is that the individual is being evaluated for IHCP eligibility. This does NOT mean they are enrolled in Medicaid. The note is relevant for providers that are billing Medical Review Team procedure codes. For example, the individual may have applied for Medicaid for the Disabled and the Medical Review Team requested they have a medical evaluation done. The provider who completes the evaluation may bill for the service of completing the evaluation.