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Riding the Enrollment Assistance Roller Coaster

Join Joanne Hermiston & Melissa Bell to learn about ACA enrollment requirements, clinic workflows, and common pitfalls to avoid. Discover why ACA enrollment is important for patients, staff, clinics, and the community, and how it can benefit them. Gain insights into the certification processes for clinic organizations and individual Certified Application Counselors (CACs), and understand the monitoring and reporting tools needed for success. Avoid common pitfalls and explore resources to streamline the enrollment assistance process.

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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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