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Riding the Enrollment Assistance Roller Coaster

Riding the Enrollment Assistance Roller Coaster. With Joanne Hermiston & Melissa Bell. Objectives. CAC requirements Processes involved & Clinic workflows Common pitfalls to avoid. Where do you stand???. Why is ACA enrollment important?. Some who benefit from it are… Patients S taff

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Riding the Enrollment Assistance Roller Coaster

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  1. Riding the Enrollment Assistance Roller Coaster With Joanne Hermiston & Melissa Bell

  2. Objectives • CAC requirements • Processes involved & Clinic workflows • Common pitfalls to avoid

  3. Where do you stand???

  4. Why is ACA enrollment important? Some who benefit from it are… • Patients • Staff • Clinic • Community

  5. Patients • Health coverage • Peace of mind • Avoiding penalty • Empowering them to take charge of health and education of insurance basics

  6. Staff • Increase of overall knowledge of how pieces fit together • Better understanding of insurance in’s & out’s • Satisfaction from helping individuals

  7. Clinics • Increased ability to bill for services provided • Increased revenue for clinics • Right thing to do for your clinics to better serve the patient • Another service that can be offered to patients

  8. Community • Decrease overall number of uninsured • Individuals and families can get health needs met • Lessen financial burdensrelated to health care • Encourage healthier behaviors • Increase healthcare visits – preventive care • Decrease unnecessary ER visits

  9. What’s involved??? • Certification process for clinic organization (CDO) • Internal clinic workflow processes • Materials • Identifying eligible individuals • Appointment screening & scheduling • Assistance & education • Tracking & reporting

  10. What’s involved??? • Individual CAC Certification process • Signed CAC agreement with CDO • Training courses through CMS for CAC’s • 7 required modules (2017) & 5-10 hours to complete • CDO issues an official CAC certificate • Open enrollment begins November 1st, 2016

  11. Monitoring Progress Tracking & Reporting: • Quarterly Dashboard Report (clinic goals) • FPCI & OPA reporting • Other agency reporting * Consider all factors to determine success!

  12. Avoiding Common Pitfalls • Time • Assistance area considerations • What’s needed for appointments • Helpful tools • Partnerships/Resources • Lessons learned

  13. INCOME GAME Iowa Wellness Plan Marketplace Iowa Marketplace Choice Plan Private Broker EmployerInsurance

  14. Questions...

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