Administrative Care Coordination / Ombudsman Services

HealthCare Access Maryland’s (HCAM) Care Coordination Program serves as the Baltimore City Administrative Care Coordination Unit (ACCU). The ACCU serves as a local resource for all HealthChoice members.

HealthChoice is Maryland’s Medicaid managed care program. Most people that qualify and receive Medicaid, are required to enroll in a Managed Care Organization (MCO). There are 9 MCOs to choose from:

Each MCO has a group of doctors, clinics, and other health care providers who work together to take care of HealthChoice members’ health care needs.

Community Outreach Workers can:

  • Help you understand your HealthChoice benefits and how to access services.
  • Explain your MCO options including MCO Selection, annual right to change, and MCO disease and case management services.
  • Help you find a Primary Care Doctor or Specialists in your MCO’s network.
  • Explain how to apply and renew your Medicaid benefits through the Maryland Health Connection.
  • Help address problems like resolving a bill, updating your information, getting new insurance cards or filing an appeal or grievance for health services.
  • Connect you to services not covered by your MCO; dental, mental health and substance use disorder services.
  • Assist with removing barriers to healthcare by linking to housing, domestic violence services, Energy Assistance, and Medical Assistance Transportation.
  • Coordinate care for pregnant women and infants in Baltimore City, and make referrals to Baltimore City’s home visiting programs, WIC, the Infants and Toddlers Program.

Ombudsman Services are available to every HealthChoice member. An Ombudsman acts an advocate for Medicaid recipients. The Community Ombudsman works along with the HealthChoice MCO representative to ensure that members receive Medicaid benefited services and help to resolve complex medical issues involving care coordination with specialty providers and vendors.

  • If you have questions about Medicaid/HealthChoice benefits, call the Care Coordination Program to assist you, 410-649-0500, option 2.
  • For problems and complaints about Medicaid access, the enrollment process, or quality of care, call the Maryland Department of Health, Enrollee Help line, 1-800-284-4510.