How The OCO Has Helped Members 

Nurse and patient discussing treatment. 

How the OCO can help you!

Since March 2014, the OCO has helped more than 1,500 individuals. Here are a few examples of the ways the OCO has helped One Care plan members address and resolve One Care concerns.

Part D: Drug Coverage

- We help members gain access to their prescription medications when there is a glitch in the system.

Member Enrollment

- We work with MassHealth and each of the One Care plans to address enrollment and disenrollment related problems and questions.

Provider Access

- We investigate provider access issues, such as transportation problems, access to qualified interpreters for the Deaf, parking and building accessibility, and other access issues.

Single Case Exceptions

- We work with One Care plans to implement single case exceptions so some members can continue to receive services from a preferred provider.

Timely Service Delivery

- We work with One Care plans to improve their timely delivery of services to members.

How the oco has helped Members:

  • The OCO assisted a One Care member who required immediate Chore and Homemaker services per a Board of Health request. OCO staff worked with One Care Plan Member Service Manager in finding a vendor who could perform the necessary services that met the Board of Health criterion.

  • A One Care member with a visual impairment contacted the OCO. The member’s glasses were lost and they did not have a replacement pair. OCO worked with One Care Plan Service Manager. The member received a new pair of glasses within 48 hours of contacting the OCO.

  • A One Care Plan member’s request for a dental crown was denied. The OCO investigation discovered that the dental provider had not completed the Prior Authorization paperwork. OCO worked with the provider, the member and their One Care plan to ensure that all the required paperwork was completed. The denial was overturned and the member received their dental crown.