SlideShare une entreprise Scribd logo
1  sur  76
DOCTORS CARE PROGRAM
GROUP INFORMATION SESSION
      New and Returning Applicants 2012
AGENDA

1.    Introduction
2.    Paperwork in Packet
3.    Percentage Payments
4.    PCPs & Specialists
5.    Hospital Services
6.    Prescriptions & Supplies
7.    On-Site Services
8.    Renewal
9.    Frequently Asked Questions (FAQ)
10.   Last Reminders
11.   Next Steps
12.   Set up Appointment
AGENDA

1.    Introduction
2.    Paperwork in Packet
3.    Percentage Payments
4.    PCPs & Specialists
5.    Hospital Services
6.    Prescriptions & Supplies
7.    On-Site Services
8.    Renewal
9.    Frequently Asked Questions (FAQ)
10.   Last Reminders
11.   Next Steps
12.   Set up Appointment
INTRODUCTION


Welcome to Doctors Care!

1. Why are you here?
2. My goal today…
3. You need to…
4. Today’s session will…
5. Our next step after today’s session…
WHO WE ARE

 Background:
   Doctors Care was started by the Arapahoe Medical
    Society in 1988.
   This program is supported by hospitals and physicians
    volunteering their time and services for medically
    underserved patients.
 Our goal is to allow everyone on the program to
 have access to complete health care.
    However, because we rely on community physicians
     volunteering their time, sometimes we do have a wait list
     for primary care and specialties. We do our best to move
     patients off the wait list as quickly as possible.
WHAT WE’RE NOT

   We are not insurance
       Physicians & hospitals do not receive any payment from us
       You do not pay a monthly or yearly amount in order to use our
        services.


   We are not a long term program.
       Each patient over 18 has a maximum of two years of coverage
        in his or her lifetime.
ARE YOU ELIGIBLE?

1.   Do you have any kind of health insurance?
        We do not provide care for those who already have health
         coverage, even if it is minimal or unaffordable coverage
        That includes CICP, Medicaid, Medicare, MCPN, etc.
2.   Do you live in our service area?
        We only serve patients living in Douglas, Elbert, or Arapahoe
         counties excluding the city of Aurora.
3. Do you have a medical concern?
        We do not provide any physicals and preventative care for
         adults, b ut there are other programs that do.
        Asking your PCP for physicals and preventative care can result in
         termination from the program.
        This program is not intended for backdating purposes only.
         Therefore to qualify for this program you must have a need for
         ongoing medical care.
BACKDATING

 Once you come on the program we do provide a 90
 day backdating service.

 Any bills from our partner hospitals can be
 backdated up to three months.
    This service will not count against your two years on the program.


 Just remember to bring any bills you have as well as
 any receipts for payments to your next appointment.
    NOTE: If you haven’t received the bills yet, please don’t wait to make
     an appointment for your individual financial review. Sometimes those
     bills can take a while to come through, and you might pass your 90
     day limit before they arrive. They are not required for eligibility.
AGENDA

1.    Introduction
2.    Paperwork in Packet
3.    Percentage Payments
4.    PCPs & Specialists
5.    Hospital Services
6.    Prescriptions & Supplies
7.    On-Site Services
8.    Renewal
9.    Frequently Asked Questions (FAQ)
10.   Last Reminders
11.   Next Steps
12.   Set up Appointment
PAPERWORK IN PACKET

   Patient Guidelines
   Contract for Participation
   HIPAA Release of Information
   Authorization for use and disclosure of PHI
   How are you Feeling?
   Medical History
   PCP Acknowledgment for Mental Health
   Additional Packet info
       Request for resources
       Thank you!
       CT/MRI
       Staff business cards
 GIS Survey
REQUIRED PAPERWORK


 Don’t worry- you will have time after the
 presentation to fill these out and ask questions!

 Nothing is required today.
    If you have your paper work with you today, please just
     place it in the purple folder we have given you and bring it
     back with you when you come in for your Individual
     Financial Intake appointment.

 If you have any questions about the financial
 paperwork you brought in today, feel free to ask
 questions after the presentation.
PATIENT GUIDELINES


 This is a detailed outline of all
 rules that must be followed
 during your time on Doctors
 Care.

 Keep these guidelines and refer
 to them when you have
 questions.

 Read through at home and ask
 questions at your next meeting
CONTRACT FOR PARTICIPATION

 Each adult applying for the program will need
 to fill out a Contract for Participation.

 Please initial each line and sign & date the
 form.

 You will be held accountable to this form!
   Please be sure that you understand everything
    BEFORE signing.
   We will copy this form so that you may also
    keep a copy for your records.
HIPAA RELEASE OF INFORMATION

 Each family member must have a HIPAA form
 on file to be covered.

 Parent or guardian must fill out for each child
 under the age of 18.

 We also require that you not line through the
 options for sharing drug, alcohol, and
 psychological information to be part of the
 Doctors Care program.
    If you have concerns regarding this, please wait and
     speak with me individually after the session. You can
     decide whether or not to sign at that time.
Authorization for use and disclosure of PHI


 If you would like Doctors Care the option of leaving
 messages on any voicemail, please indicate
 so, otherwise we will leave a generic message that
 we have called.

 If you would like other individuals to have access to
 your health information, please indicate so on the
 form, without your consent, Doctors Care will not be
 able to release any information to anyone other than
 yourself.
HOW ARE YOU FEELING TODAY?

 This is not just a polite question- it’s another form we
  need you to fill out.

 Please answer honestly: these results are kept
  confidential.

 Each adult applying for coverage needs to fill out this
  form at intake and for every renewal.

 You may skip the final two questions on the back at this
  time unless you have been part of Doctors Care
  previously.
MEDICAL HISTORY


 Your application includes a brief
 medical history form. Must be
 completely filled out.

 Please take one of these for each
 adult applying for coverage.
ADDITIONAL PACKET INFORMATION

 Request for Resources
   If you are interested in any of the resources listed on
    this page, please fill out and turn in today or return at
    your financial screening.
   A Doctors Care volunteer will contact you regarding
    community resources available in your areas of need.
 “Thank You!”
 “CT/MRI Scans”
 Staff business cards
 GIS survey
AGENDA

1.    Introduction
2.    Paperwork in Packet
3.    Percentage Payments
4.    PCPs & Specialists
5.    Hospital Services
6.    Prescriptions & Supplies
7.    On-Site Services
8.    Renewal
9.    Frequently Asked Questions (FAQ)
10.   Last Reminders
11.   Next Steps
12.   Set up Appointment
COST OF SERVICES


 You are responsible for the percentage payment
 listed on your card.
    This is determined by a sliding fee scale based on your individual
     financial situation.
    Example: An MRI costs $1000 and your percentage payment is
     20%. You pay $200, and the doctor’s office donates $800 to cover
     the remaining cost.
 You must pay your entire percentage payment at the
 time of service.
    If you know you will be unable to pay the full amount at the time of
     service, you must make a payment plan with the provider before
     your appointment.
PERCENTAGE PAYMENT PLANS

 You will be assigned to one of the following plans:
  Plan   Percent   Physician   Lab/        Outpatient   Inpatient   Pharmacy
         Payment               Radiology   Hospital     Hospital
         %

  A      5%        5%          5%          5%           5%          $10
  B      10%       10%         10%         5%           5%          $10
  C      20%       20%         20%         10%          5%          $10
  D      30%       30%         10%         10%          10%         $15
  E      50%       50%         20%         20%          10%         $15
  F      75%       75%         20%         20%          10%         $15
 This will be described in greater detail at your next
  meeting, and you’ll be given a comprehensive benefit
  plan for your individual situation.
FIRST IMPORTANT RULE


1. Pay your percentage payments
PAY YOUR PERCENTAGE PAYMENTS

 If you fail to provide your Percentage payment at the
 time of service you will not be able to keep your
 appointment and it will be recorded as a no-show.
    Repeated failures to provide your payment at the time of service will
     result in termination from the program.


 If you fail to pay on your arranged payment plan on
 time, you may be terminated from the program
 and/or sent to a collections agency.
    Any bill which is turned over to a collection agency will have the
     discount reversed (you will be sent to collections for 100% of the
     cost) and you will be immediately terminated from the program.
AGENDA

1.    Introduction
2.    Paperwork in Packet
3.    Percentage Payments
4.    PCPs & Specialists
5.    Hospital Services
6.    Prescriptions & Supplies
7.    On-Site Services
8.    Renewal
9.    Frequently Asked Questions (FAQ)
10.   Last Reminders
11.   Next Steps
12.   Set up Appointment
YOUR PRIMARY CARE PHYSICIAN

 Every person on the Doctors Care program must
  be assigned to a Primary Care Provider(PCP).
     Patients 30 years or younger will be assigned to the
      Doctors Care Clinic.
     Patients over 30 years will be assigned to a participating
      provider in the community.
 If you are established with a provider not in our
  network, you may choose to be assigned to an
  “Out of Network” physician, but you will be
  responsible for all charges with that provider.
 The PCP’s office will serve as your Medical
  Home.
     They will house your medical records.
     You will use this physician for medical
      care and specialist referrals.
FIRST APPOINTMENT

 You must set up an initial appointment with your PCP
 during your first month of eligibility.
    Failing to do so indicates that you aren’t in need of medical
     coverage and will result in termination from the program.
 Let them know you are on the Doctors Care program
  when you call to make your appointment.
 Be prepared to bring your card and your percentage
  payment for every appointment.
 Start gathering your medical history paperwork
  now to speed up the process with your new PCP.
LIMITATIONS WITH PROVIDERS

 Your doctor (PCP or otherwise) is not required to
  fill out any paperwork or forms unrelated to
  Doctors Care. In addition physicals are not
  covered by Doctors Care and can be obtained
  through other resources in the community.
     That includes any forms for Social Security, Disability, or Worker’s
      Compensation.
     These may contain phrases like “how long can you sit in a chair”
      or “how many pounds can you comfortably lift” etc.


 Telling a provider to add to or change what he/she
  wrote down is also inappropriate and is grounds for
  termination from Doctors Care.

If you have a form and wonder whether or not a
doctor will fill it out, please give Char a call.
SPECIALIST REFERRALS


 All specialist referrals must be made through the
  Doctors Care office.
     Have your referring physician call, fax, or email Char the information and
      she will notify you of the specialist’s name and phone number when the referral
      is complete.
 Doctors Care has over 95 different specialties within
  our network, so almost everything can be covered.
 Not all physicians, their services or facilities in the area
  are covered under Doctors Care.
     You could be held responsible for these charges if you don’t obtain a proper
      referral.
 Some specialists are in high demand, and there may be
  a wait list to be seen.
     We will let you know if this is the case and talk through your options at that
      time.
ALTERNATIVE MEDICINE


 Doctors Care also has many
 alternative medicine providers
 such as:
    Acupuncture
    Chiropractic
    Massage Therapy
    Yoga Therapy

 You may self-refer if you are interested in
 receiving alternative treatment. Simply
 call Char and she will set it up for you.
THREE MORE IMPORTANT RULES


1. Pay your percentage payments
2. Be respectful
3. Show up for appointments
4. Follow through with treatment recommendations
BE RESPECTFUL

 All of our providers are volunteers, so there is a strong
  expectation that all physicians and their staff members
  will be treated with courtesy and respect.

 Lack of respect by our members harms our
  relationships with these providers, and they may not
  wish to see future patients.
     Because this is a chance we’re not willing to take, lack of respect
      is grounds for termination.

 If you have an issue or concern regarding one of our
  providers or their staff, please call us so that we may
  mediate on your behalf.
SHOW UP FOR APPOINTMENTS


 You are responsible for scheduling all of your
 own appointments.
    If you cannot keep an appointment, you must call to
     cancel within a minimum of 24-48 hours ahead of time.
     Not doing so is equivalent to not showing up at all.

 Three or more no-shows for a PCP will result in
 termination from the program.

 One no-show for a specialist visit is grounds for
 termination.
FOLLOW THROUGH ON REFERRALS

 Not following through on
  referrals from your provider is
  also considered a lack of
  respect.

 If you have an issue or
  concern regarding the
  treatment
  recommendations, please call
  the Patient Care Coordinator
  and ask if she can set up an
  appointment to get a second
  opinion.
AGENDA

1.    Introduction
2.    Paperwork in Packet
3.    Percentage Payments
4.    PCPs & Specialists
5.    Hospital Services
6.    Prescriptions & Supplies
7.    On-Site Services
8.    Renewal
9.    Frequently Asked Questions (FAQ)
10.   Last Reminders
11.   Next Steps
12.   Set up Appointment
HOSPITALIZATION

 Doctors Care partners with five hospitals:
   Swedish Medical Center
   Porter Adventist Hospital
   Littleton Adventist Hospital
   Sky Ridge Medical Center
   Parker Adventist Hospital
   Castle Rock Adventist (pending)


 You will be assigned to one of these hospitals, and must use only
  that hospital for all inpatient or outpatient
  treatments, pharmacy, lab, x-ray, etc, unless it has been pre-
  authorized by Doctors Care.
 Check in at the registration desk before your appointment and
  the staff will tell you where to go.
 Please be prepared to present your card and pay your entire
  percentage payment at the time of service for any planned
  procedures.
     If you need to arrange a payment plan, you will probably be required to pay at
HOW HOSPITAL BILLS WORK


 Any procedure done at the hospital will result in at least
  two bills:
  1. Hospital
  2. Doctor who interprets the test or procedure

 Other bills you may receive in addition to the hospital bill
  could be for:
     The doctor who performs the procedure
     Anesthesiology
     Radiology
     Pathology
     Etc.
RADIOLOGY


 X-rays and other radiology services need to be performed
  at your assigned hospital.

 Your physician will send over the request to the hospital
  and assist you in scheduling if needed. (Some services are
  walk-in.)
     Remember to check in at registration!

 NOTE: For inpatient hospital services, you will be
  responsible for both the percentage payment for the
  hospital that performs the service as well as the physician
  who reads your films.
     The physician bill will likely come in the mail from Radiology Imaging
      Associates or Diversified Radiology.
     This bill should be automatically adjusted to your percentage
      amount. If it is not, please call them immediately to let them know of
      your Doctors Care status so that it can be changed.
CT AND MRI SCANS


 Doctors Care has a special arrangement with
 one of our radiology partners to provide an
 option when scheduling CT and MRI scans.
    These are performed for the physician’s payment percentage rate instead
     of the hospital’s rate.
    Depending on which plan you’re on, this could mean your CT or MRI scan
     will be a fraction of the cost of having it done in the hospital.


 These appointments must be scheduled through
 the Patient Care Coordinator, Char.
    These appointments are subject to availability.
    Have your physician contact her to get this set up instead of contacting the
     hospital directly.
LAB TESTS


 Any lab tests like blood work must be completed at your
  assigned hospital’s lab.

 Don’t allow your doctor’s office to draw blood.
     You will be responsible for 100% of anything that is drawn at the physician’s office.
     We don’t work with Quest or LabCorp, so be sure not to use them!



 Have your physician give you a written prescription or call
  in the order to the hospital laboratory.
     Check in at hospital registration with your Doctors Care card, and the staff will
      direct you to the lab.
     Be sure to only use the hospital-run lab.
ANESTHESIOLOGY


 Doctors Care partners with:
   Guardian Anesthesia

   South Denver Anesthesiologists

   Colorado Anesthesia Consultants

   OB/GYN Anesthesiologists.



 Those groups are listed in your
  guidelines.

 Any services performed by one of these
  groups will be covered under Doctors
  Care.
ANESTHESIOLOGY


 They are the primary groups that work with our
  hospitals and doctors, but are not the only anesthesia
  groups in the South Metro area.

 If you are planning a surgery, please request that your
  doctor use one of these groups.

 If you receive a bill from them that does not appear to
  be adjusted to your percentage payment, please
  contact their billing office right away to inform them of
  your Doctors Care participation.
EMERGENCY ROOM


 Emergency room visits are expensive and designed
 for true emergencies only.

 If you use the emergency room, the hospital portion
 of your bill will be covered, however the ER physician
 cost will be completely your responsibility.

 While we have informal agreements with certain
 ambulance providers, this is not an official covered
 benefit, and you may be responsible for 100% of this
 cost as well.
    Please contact Char if you receive an ambulance bill to
     determine if there may be a way to have it reduced.
ABUSE OF THE EMERGENCY ROOM


 Using the emergency room for inappropriate reasons
  is grounds for termination from the Doctors Care
  program.

 Doctors Care receives monthly reports from the
  hospitals of our patients who use the ER.

 Inappropriate uses include (but are not limited to):
     Sore throat
     Sinus infection
     Diaper rash
     Obtaining pain or refill medication
HOW TO USE THE ER


If you feel you have a situation that can’t wait
until the physician office opens but is not life-
threatening:

1. Call your doctor’s office and follow the advice
   given by the after-hours provider.
      If you are told to go to the ER by this provider, it will not
       be considered abuse, and you should follow all
       instructions given.
2. If you do go to the ER, call Doctors Care as
   soon as possible afterwards.
      This will let us know that you were not trying to abuse
URGENT CARE IS AN OPTION

 As another option for after-hours care, Doctors Care
  partners with Doctors Express, an urgent care clinic
  that is open 8 a.m. to 8 p.m. , 365 days a year.
 Please still call your PCP before accessing urgent
  care.
 This is a much cheaper option than using the
  Emergency Room, and they will also see you with
  less of a wait time.
    901 W. Hampden Ave.
    Englewood, CO 80110
    (303) 761-1699

 $25 for Plans A, B and C
 $50 for Plans D, E and F
AGENDA

1.    Introduction
2.    Paperwork in Packet
3.    Percentage Payments
4.    PCPs & Specialists
5.    Hospital Services
6.    Prescriptions & Supplies
7.    On-Site Services
8.    Renewal
9.    Frequently Asked Questions (FAQ)
10.   Last Reminders
11.   Next Steps
12.   Set up Appointment
PRESCRIPTIONS

 Prescriptions are only filled when written by a participating
  provider.
     If you are using an out-of-network provider, contact Char to see if you
      can get special authorization for your prescription.

 Prescriptions covered by Doctors Care can only be filled at
  your assigned hospital’s outpatient pharmacy.
     See list in the Patient Guidelines

 Only generic prescriptions are covered.
   If your provider needs you to be on a prescription with no generic
    substitutes, have them call Char to see if it can be specially
    authorized.

 Please allow 24 hours for any refills.
   This will allow the pharmacy time to call the physician for approval if
    needed.
PRESCRIPTION COSTS

 Your prescription cost depends on your percentage
  payment.
     Plans A, B and C: $10 pharmacy co-pay; Plans D, E and F: $15.
 This payment covers a one-month supply or one package
  size.
     Example: One inhaler or one vial of insulin
 There is a very small possibility that the pharmacy will not
  stock your prescription. It can’t be special ordered and you
  will have to go to a retail pharmacy to pay full price.
 King Soopers, Target, and Wal-Mart all have certain generic
  prescriptions available for $4.
     This is NOT associated with Doctors Care and not all generics are on this
      list.
     Feel free to call other places to see if their retail price is less than your Doctors
      Care co-pay.
     If you do so, DO NOT present your Doctors Care card, as it is not accepted at
      these locations.
DIABETIC SUPPLIES

 Needles for diabetics will be covered in one-month
  increments.
     One co-pay will cover 50 needles.

 Doctors Care will cover 50 generic test strips per co-pay.
   You may have to buy the generic meter that works with the generic
    strips carried in your pharmacy, usually between $15-$20.
   If you want to use brand name test strips, you’ll have to pay full price.


 Brand name insulin will need to be obtained through the
  drug manufacturer’s Patient Assistance Plan.
     Doctors Care will cover your first two months at one co-pay per vial
      while you are getting signed up. There will not be any extensions.
     Contact Char if you need help obtaining the paperwork or filling out
      the forms for this program.
     Start filling out this paperwork as soon as you know you will need
      insulin. It can take up to two months for the paperwork to be
      processed.
SUPPLIES NOT COVERED

 Over-the-counter drugs                      Nicotine replacement therapy
 Any supplies that can be                    Acne therapy for anyone over
  purchased                                    18
  without a prescription                      Mental health medications
 Birth control medications                   Medical supplies
     If this is being prescribed for non-       o   Examples:
      contraceptive uses, have your                  oxygen, wheelchair, hardware, etc.
      provider contact Char for
      authorization
 Appetite suppressants
 Weight loss drugs
 Erectile dysfunction medications


           Most of these supplies are available for free or
           discounted prices through other services in our
           community. Please mark the “Request for Resources”
           page for contact information.
SERVICES NOT COVERED


 Glasses/Optical care
 Dental
 Elective care
 Adult physicals/preventive care



Please contact us if you need help with
anything not covered by Doctors Care, as we
often know of community resources to help
with these needs.
SUBSTANCE ABUSE & DEPENDENCE

 Doctors Care screens and diagnoses for signs
 and symptoms of drug and alcohol dependence
 and abuse.
    We will refer clients, when indicated, to community resources
     equipped to treat dependence and abuse.
    Doctors Care mental health providers will continue to counsel and
     support clients to encourage them to stay engaged in appropriate
     treatment facilities or other community programs.

 Doctors Care is not equipped to provide drug or
 alcohol treatment or to detox to anyone.

 However, if it’s determined that you have
 dependence or abuse issues, you may be
 required to follow through on a referral to a
 treatment program outside of Doctors Care to
 remain eligible for the program.
AGENDA

1.    Introduction
2.    Paperwork in Packet
3.    Percentage Payments
4.    PCPs & Specialists
5.    Hospital Services
6.    Prescriptions & Supplies
7.    On-Site Services
8.    Renewal
9.    Frequently Asked Questions (FAQ)
10.   Last Reminders
11.   Next Steps
12.   Set up Appointment
THE DOCTORS CARE CLINIC

 For children and young adults up to age 30, the clinic provides
  appointments for most illnesses and injuries.

 Percentage payments for an office visit are listed in your guidelines.
 Office hours: M-TR 9am-5pm and F 9am-4pm.
 Please call to set up an appointment.
     Walk-ins are not accepted.
     Same day appointments are generally available if needed.


 Annual physicals for ages 3-18: regular co-pay + lab costs.
     Children under 3 may need to be seen more frequently for
      check-ups and immunizations. These visits are covered for
      regular co-pay plus lab costs.
MENTAL HEALTH


 We currently have one therapist and one psychiatric mid-level
  provider on site for mental health counseling appointments
  and medication management, as well as many off-site
  counselors.

 You may self-refer or your PCP may refer for mental health
  appointments.

 Contact Char to set up mental health appointments.

 Our mental health professionals will be available to provide
  counseling or therapy.

 We do have resources here at Doctors Care that we can use
  so you can obtain Mental Health medications for low cost.
MENTAL HEALTH APPOINTMENTS

 Plan   On-site Mental
                         Remember to contact Char if you
        Health Visit
                         would like to get an appointment
 A      $10              set up.
 B      $15
                         Counselors off-site may have
 C      $15
                         different pricing structures, but
 D      $20              are also available outside regular
 E      $30              office hours.
 F      $30
AGENDA

1.    Introduction
2.    Paperwork in Packet
3.    Percentage Payments
4.    PCPs & Specialists
5.    Hospital Services
6.    Prescriptions & Supplies
7.    On-Site Services
8.    Renewal
9.    Frequently Asked Questions (FAQ)
10.   Last Reminders
11.   Next Steps
12.   Set up Appointment
PROGRAM RENEWAL

 Your first card will expire in 90 days. This is a probationary period to
  ensure proper usage of the Doctors Care program.
   You will automatically receive a new card about one week prior to this
    90-day period for an additional 90 days, assuming there have been
    no concerns.
 You will need to renew your Doctors Care card every six months by
  resubmitting the renewal application and financial documents. Please
  make sure theses documents are filled out thoroughly.
 A packet containing all required paperwork will be mailed to you
  approximately one month before each six month expiration.
     If for any reason this packet does not arrive, please contact our office to
      request that we send another one or to arrange pick-up at the office.
 If you lose your card, you will be charged $1 for a replacement
  card.
AT YOUR RENEWAL


 If you do not need Doctors Care anymore at the
 time of your renewal, please let us know.
    Doing so will allow others in need to use the services
     provided by our partners.
    You will also be granted the opportunity for backdating up to
     90 days again should you need to reapply in the future.


 Failing to inform us of your decision to quit Doctors
 Care will result in a loss of the ability to backdate
 your care in the future.
RENEWAL PROCESS

 You will not need to come in for an appointment for your
  renewal. Simply drop off or mail your paperwork.
     Your documents will be processed by eligibility counselors and the
      new card(s) sent by mail.
     We do need you to re-submit all financial documents, even if your
      situation has not changed.

 If you do not submit your paperwork by your expiration date,
  you will automatically be discontinued from the program.
     You will be eligible to reapply, but will have to restart the application
      process.

 There is no guarantee that you will be able to stay with the
  same physicians if this happens, as your spot will quickly be
  given to another patient in need.
AGENDA

1.    Introduction
2.    Paperwork in Packet
3.    Percentage Payments
4.    PCPs & Specialists
5.    Hospital Services
6.    Prescriptions & Supplies
7.    On-Site Services
8.    Renewal
9.    Frequently Asked Questions (FAQ)
10.   Last Reminders
11.   Next Steps
12.   Set up Appointment
FREQUENTLY ASKED QUESTIONS


 What should I do if I get a bill in the mail that is not
  adjusted to my percentage payment amount?
     First call the billing office as SOON as you receive the bill to
      inform them of your Doctors Care status and payment level.
     If this does not resolve the issue, contact Char and she will
      work to get the bill appropriately adjusted.

 What happens if I accidentally use a provider, lab, or
  pharmacy outside of the network?
     Unfortunately, we are not able to provide assistance for any
      services incurred outside of our network.
     However, most companies will provide some level of discount
      and/or payment plan for individuals without insurance.
SERVICES


 Is there anywhere I can go to get my yearly
 mammogram or well-woman exam?
    Tri-county Health Department offers these for low cost. Please
     request the contact information in your “request for resources”
     form.
    In addition, Doctors Care has been given a grant for free
     screening mammograms for any woman over 40 who does not
     have insurance. Ask at the front desk for an application and
     voucher.

 I have been told I should get a colonoscopy screening
 every year. Is that covered?
    Routine screenings (suggested for everyone over 50) are not
     covered, but are offered for free by the Colorado Colorectal
     Screening Program.
    Screenings required because of a medical concern
     are covered and will need a referral like any other specialist.
THE WAIT LIST


 If I am placed on the wait list for a physician, how long will I
  have to wait?
     There is no way for us to know how long you may have to wait.
     All our staff are committed to increasing our network of providers to
      hopefully eliminate the wait list altogether.
     We can tell you how many people are ahead of you on the wait list.
     Historically, the wait list for a PCP has moved relatively quickly.
      However, specialist waitlists are very unpredictable.
 What if my condition is urgent and I cannot wait?
     Our wait list is strictly first come, first serve. There is no way for a person to
      jump to the “head of the line.”
     If you or your doctor feel you cannot wait, you have the option at any time to
      see a community provider as a self-pay patient.
     If you choose to see a provider as a self-pay patient, you may still utilize the
      hospital, lab, radiology, and possibly pharmacy services through Doctors
      Care.
AGENDA

1.    Introduction
2.    Paperwork in Packet
3.    Percentage Payments
4.    PCPs & Specialists
5.    Hospital Services
6.    Prescriptions & Supplies
7.    On-Site Services
8.    Renewal
9.    Frequently Asked Questions (FAQ)
10.   Last Reminders
11.   Next Steps
12.   Set up Appointment
WHEN TO CONTACT US


 Please notify Doctors Care within ten days of any
  change in :
     Address
     Phone number
     Financial or job situation
     Insurance status
     Family status
 Feel free to call the Patient Care Coordinator, Char, with
  any questions or concerns.
     If you ever have any issue with one of our providers or their
      staff, please contact us to mediate the situation.
     If you would ever like a second opinion from a specialist, please
      contact Char to get it set up.
LAST IMPORTANT RULE


1. Pay your percentage payments
2. Be respectful
3. Show up for appointments
4. Follow through with treatment
   recommendations
5. Communicate
COMMUNICATE


Communicate, communicate, communicate!
        Follow up on bills as soon as you receive them to make
         a payment plan or adjust the bill to your percentage
         payment amount.
        If you need to use the ER, call your PCP’s after-hours
         physician and follow their advice FIRST.
          If you do use the ER, please call us as soon as you can
           afterwards and let us know the situation.


If you have ANY questions, please call Char.
        We understand that there are a lot of rules to remember.
         We are keeping you accountable to those rules, so please
         contact us to ask questions rather than possibly making a
         mistake.
AGENDA

1.    Introduction
2.    Paperwork in Packet
3.    Percentage Payments
4.    PCPs & Specialists
5.    Hospital Services
6.    Prescriptions & Supplies
7.    On-Site Services
8.    Renewal
9.    Frequently Asked Questions (FAQ)
10.   Last Reminders
11.   Next Steps
12.   Set up Appointment
FINANCIAL INTAKE


 Bring ALL documents and paperwork to your next appointment!
     We can’t process your application until we have all requested
      documents listed in your application as well as the paperwork you
      received today.
     NOTE: Remember that hospital bills are not required for this
      appointment, but do bring them if you have them.

 If you have all required documentation, you will either be
  assigned to a physician or placed on the wait list at the time of
  your financial screening.
   If you are placed on the wait list, you will be called as soon as a
    spot opens up.
   You will have 48 hours to verify that you want the slot or it will be
    given to someone else and you will be moved to the bottom of the
    wait list.
EXTRA PAPERWORK


 Additional forms are needed if you are:
    Self-employed
    Living with a friend or family member (not on a
     lease)
    Signing up additional adults
    Signing up children


 You may also need a medical history
 form if you haven’t filled one out.
WHAT DO I NEED TO TURN IN TODAY?



 Nothing is required today.
 Please remember there is additional
  information in your purple packet that you will
  need to read over, fill out, and bring with you
  when you attend your financial intake
  appointment.
 If you have any questions about the financial
  paperwork you brought in today, feel free to
  ask questions after the presentation.
5 RULES TO REMEMBER



1. Pay your percentage payments
2. Be respectful
3. Show up for appointments
4. Follow through with treatment
   recommendations
5. Communicate
CONCLUSION


Thank you for coming today!

1.   My goal today was to teach you how Doctors
     Care works and what your role will be in our
     program.

2.   You need to follow our rules and regulations
     to be part of the program, and we’re here to help
     you along the way.

3.   Our next step is to schedule a Financial Intake
     appointment.
AGENDA

1.    Introduction
2.    Paperwork in Packet
3.    Percentage Payments
4.    PCPs & Specialists
5.    Hospital Services
6.    Prescriptions & Supplies
7.    On-Site Services
8.    Renewal
9.    Frequently Asked Questions (FAQ)
10.   Last Reminders
11.   Next Steps
12.   Set up Appointment
MAKE AN APPOINTMENT


 Appointment cards for your financial screening
  meeting are at the end of the table.
 There are two cards in each pile, both with the
  same time and date.

1. Card one:
   Write your name and phone number and turn
   in today so I can put you in our calendar.

2. Card two:
   Keep it for yourself as a reminder!

Contenu connexe

Tendances

2012 RMC Benefit Presentation
2012 RMC Benefit Presentation2012 RMC Benefit Presentation
2012 RMC Benefit Presentationriversidemc
 
The Clinic M 2 Presentation
The Clinic M 2 PresentationThe Clinic M 2 Presentation
The Clinic M 2 Presentationguestb6fe6
 
Medicare Education by Ray McPherson
Medicare Education by Ray McPhersonMedicare Education by Ray McPherson
Medicare Education by Ray McPhersonJacob MacArthur
 
2015 City & County of San Francisco New Employee Orientation: Health Benefits
2015 City & County of San Francisco New Employee Orientation: Health Benefits2015 City & County of San Francisco New Employee Orientation: Health Benefits
2015 City & County of San Francisco New Employee Orientation: Health Benefitssfhss
 
VEBA Plan & How to Fill Out A PHQ
VEBA Plan & How to Fill Out A PHQVEBA Plan & How to Fill Out A PHQ
VEBA Plan & How to Fill Out A PHQMitchell Bigley
 
Philip Eskew, DO, JD, MBA - Legal Risk Mitigation for DPC Physicians - DPC Su...
Philip Eskew, DO, JD, MBA - Legal Risk Mitigation for DPC Physicians - DPC Su...Philip Eskew, DO, JD, MBA - Legal Risk Mitigation for DPC Physicians - DPC Su...
Philip Eskew, DO, JD, MBA - Legal Risk Mitigation for DPC Physicians - DPC Su...Hint
 
10 medical issues not covered by traditional medicare
10 medical issues not covered by traditional medicare10 medical issues not covered by traditional medicare
10 medical issues not covered by traditional medicareTim Barnes Clu
 
Guide to Help You Improve Your Medical Office Workflow
Guide to Help You Improve Your Medical Office WorkflowGuide to Help You Improve Your Medical Office Workflow
Guide to Help You Improve Your Medical Office WorkflowMedical Business Systems
 
6 Things Every City & County Employee Should Know About Health Benefits
6 Things Every City & County Employee Should Know About Health Benefits6 Things Every City & County Employee Should Know About Health Benefits
6 Things Every City & County Employee Should Know About Health Benefitssfhss
 
MPB Health Overview ppt
MPB Health Overview pptMPB Health Overview ppt
MPB Health Overview pptC. Rod Maxson
 
Student Health Insurance Plan
Student Health Insurance PlanStudent Health Insurance Plan
Student Health Insurance Planucsfstudenthealth
 
DIS Work Flow Process
DIS Work Flow ProcessDIS Work Flow Process
DIS Work Flow ProcessLuke Keeler
 
Chronic Care Management: 6 Tips for Documentation Success
Chronic Care Management: 6 Tips for Documentation SuccessChronic Care Management: 6 Tips for Documentation Success
Chronic Care Management: 6 Tips for Documentation SuccessManny Oliverez
 
The Art of Practice Management Dental Pearls - June 2015
The Art of Practice Management Dental Pearls - June 2015The Art of Practice Management Dental Pearls - June 2015
The Art of Practice Management Dental Pearls - June 2015Marianne Harper
 

Tendances (19)

2012 RMC Benefit Presentation
2012 RMC Benefit Presentation2012 RMC Benefit Presentation
2012 RMC Benefit Presentation
 
Let Meds2Home reduce your admissions rate
Let Meds2Home reduce your admissions rateLet Meds2Home reduce your admissions rate
Let Meds2Home reduce your admissions rate
 
The Clinic M 2 Presentation
The Clinic M 2 PresentationThe Clinic M 2 Presentation
The Clinic M 2 Presentation
 
Meds2Home Presentation
Meds2Home PresentationMeds2Home Presentation
Meds2Home Presentation
 
Fall 2012: Arkfeld Notes
Fall 2012: Arkfeld NotesFall 2012: Arkfeld Notes
Fall 2012: Arkfeld Notes
 
Medicare Education by Ray McPherson
Medicare Education by Ray McPhersonMedicare Education by Ray McPherson
Medicare Education by Ray McPherson
 
2015 City & County of San Francisco New Employee Orientation: Health Benefits
2015 City & County of San Francisco New Employee Orientation: Health Benefits2015 City & County of San Francisco New Employee Orientation: Health Benefits
2015 City & County of San Francisco New Employee Orientation: Health Benefits
 
NRneeds Presentation Final PDF
NRneeds Presentation Final PDFNRneeds Presentation Final PDF
NRneeds Presentation Final PDF
 
VEBA Plan & How to Fill Out A PHQ
VEBA Plan & How to Fill Out A PHQVEBA Plan & How to Fill Out A PHQ
VEBA Plan & How to Fill Out A PHQ
 
Pharmaneek's Meds2Home Presentation
Pharmaneek's Meds2Home PresentationPharmaneek's Meds2Home Presentation
Pharmaneek's Meds2Home Presentation
 
Philip Eskew, DO, JD, MBA - Legal Risk Mitigation for DPC Physicians - DPC Su...
Philip Eskew, DO, JD, MBA - Legal Risk Mitigation for DPC Physicians - DPC Su...Philip Eskew, DO, JD, MBA - Legal Risk Mitigation for DPC Physicians - DPC Su...
Philip Eskew, DO, JD, MBA - Legal Risk Mitigation for DPC Physicians - DPC Su...
 
10 medical issues not covered by traditional medicare
10 medical issues not covered by traditional medicare10 medical issues not covered by traditional medicare
10 medical issues not covered by traditional medicare
 
Guide to Help You Improve Your Medical Office Workflow
Guide to Help You Improve Your Medical Office WorkflowGuide to Help You Improve Your Medical Office Workflow
Guide to Help You Improve Your Medical Office Workflow
 
6 Things Every City & County Employee Should Know About Health Benefits
6 Things Every City & County Employee Should Know About Health Benefits6 Things Every City & County Employee Should Know About Health Benefits
6 Things Every City & County Employee Should Know About Health Benefits
 
MPB Health Overview ppt
MPB Health Overview pptMPB Health Overview ppt
MPB Health Overview ppt
 
Student Health Insurance Plan
Student Health Insurance PlanStudent Health Insurance Plan
Student Health Insurance Plan
 
DIS Work Flow Process
DIS Work Flow ProcessDIS Work Flow Process
DIS Work Flow Process
 
Chronic Care Management: 6 Tips for Documentation Success
Chronic Care Management: 6 Tips for Documentation SuccessChronic Care Management: 6 Tips for Documentation Success
Chronic Care Management: 6 Tips for Documentation Success
 
The Art of Practice Management Dental Pearls - June 2015
The Art of Practice Management Dental Pearls - June 2015The Art of Practice Management Dental Pearls - June 2015
The Art of Practice Management Dental Pearls - June 2015
 

Similaire à Cmp new information session ppt

Duties of a certified medical assistant
Duties of a certified medical assistantDuties of a certified medical assistant
Duties of a certified medical assistantNancy Higgins
 
Simplyhealth Tesco Brochure
Simplyhealth Tesco BrochureSimplyhealth Tesco Brochure
Simplyhealth Tesco BrochureSimplyhealthUK
 
FlexCare Telehealth Presentation
FlexCare Telehealth Presentation FlexCare Telehealth Presentation
FlexCare Telehealth Presentation FlexCare2015
 
FlexCare Telehealth Sales Overiew
FlexCare Telehealth Sales Overiew FlexCare Telehealth Sales Overiew
FlexCare Telehealth Sales Overiew FlexCare
 
Health Insurance and Employee Benefits
Health Insurance and Employee BenefitsHealth Insurance and Employee Benefits
Health Insurance and Employee BenefitsJonRead
 
Documents.asp
Documents.aspDocuments.asp
Documents.aspwsroth
 
Documents.asp
Documents.aspDocuments.asp
Documents.aspwsroth
 
Employee Benefit Guide Falcon
Employee Benefit Guide Falcon Employee Benefit Guide Falcon
Employee Benefit Guide Falcon Britton Gallagher
 
LinkedIn Telemedicine Final
LinkedIn Telemedicine FinalLinkedIn Telemedicine Final
LinkedIn Telemedicine FinalBill Sizoo
 
Insights Webinar - Patient Payments
Insights Webinar - Patient PaymentsInsights Webinar - Patient Payments
Insights Webinar - Patient PaymentsBen Quirk
 
Medicus Global Business Overview
Medicus Global Business OverviewMedicus Global Business Overview
Medicus Global Business OverviewRon Greenhough
 
Summer Webinar Series CCM 062315
Summer Webinar Series CCM 062315Summer Webinar Series CCM 062315
Summer Webinar Series CCM 062315Tamyra Hyatt
 

Similaire à Cmp new information session ppt (20)

Duties of a certified medical assistant
Duties of a certified medical assistantDuties of a certified medical assistant
Duties of a certified medical assistant
 
Simplyhealth Tesco Brochure
Simplyhealth Tesco BrochureSimplyhealth Tesco Brochure
Simplyhealth Tesco Brochure
 
Patient Finance
Patient FinancePatient Finance
Patient Finance
 
1 merged documents
1 merged documents1 merged documents
1 merged documents
 
Employee Benefit Guide GD
Employee Benefit Guide GDEmployee Benefit Guide GD
Employee Benefit Guide GD
 
FlexCare Telehealth Presentation
FlexCare Telehealth Presentation FlexCare Telehealth Presentation
FlexCare Telehealth Presentation
 
FlexCare Telehealth Sales Overiew
FlexCare Telehealth Sales Overiew FlexCare Telehealth Sales Overiew
FlexCare Telehealth Sales Overiew
 
Health Insurance and Employee Benefits
Health Insurance and Employee BenefitsHealth Insurance and Employee Benefits
Health Insurance and Employee Benefits
 
Telemedicine 24/7/365
Telemedicine 24/7/365Telemedicine 24/7/365
Telemedicine 24/7/365
 
Documents.asp
Documents.aspDocuments.asp
Documents.asp
 
Documents.asp
Documents.aspDocuments.asp
Documents.asp
 
Employee Benefit Guide Falcon
Employee Benefit Guide Falcon Employee Benefit Guide Falcon
Employee Benefit Guide Falcon
 
LinkedIn Telemedicine Final
LinkedIn Telemedicine FinalLinkedIn Telemedicine Final
LinkedIn Telemedicine Final
 
Insights Webinar - Patient Payments
Insights Webinar - Patient PaymentsInsights Webinar - Patient Payments
Insights Webinar - Patient Payments
 
Medicus global
Medicus globalMedicus global
Medicus global
 
Medicus Global Business Overview
Medicus Global Business OverviewMedicus Global Business Overview
Medicus Global Business Overview
 
Medicus global
Medicus globalMedicus global
Medicus global
 
Summer Webinar Series CCM 062315
Summer Webinar Series CCM 062315Summer Webinar Series CCM 062315
Summer Webinar Series CCM 062315
 
Extra help
Extra helpExtra help
Extra help
 
Healthcare Patient Finance
Healthcare Patient FinanceHealthcare Patient Finance
Healthcare Patient Finance
 

Dernier

VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...jageshsingh5554
 
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋TANUJA PANDEY
 
Call Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...
Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...
Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...narwatsonia7
 
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...Arohi Goyal
 
Lucknow Call girls - 8800925952 - 24x7 service with hotel room
Lucknow Call girls - 8800925952 - 24x7 service with hotel roomLucknow Call girls - 8800925952 - 24x7 service with hotel room
Lucknow Call girls - 8800925952 - 24x7 service with hotel roomdiscovermytutordmt
 
Book Paid Powai Call Girls Mumbai 𖠋 9930245274 𖠋Low Budget Full Independent H...
Book Paid Powai Call Girls Mumbai 𖠋 9930245274 𖠋Low Budget Full Independent H...Book Paid Powai Call Girls Mumbai 𖠋 9930245274 𖠋Low Budget Full Independent H...
Book Paid Powai Call Girls Mumbai 𖠋 9930245274 𖠋Low Budget Full Independent H...Call Girls in Nagpur High Profile
 
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any TimeTop Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any TimeCall Girls Delhi
 
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Chandrapur Call girls 8617370543 Provides all area service COD available
Chandrapur Call girls 8617370543 Provides all area service COD availableChandrapur Call girls 8617370543 Provides all area service COD available
Chandrapur Call girls 8617370543 Provides all area service COD availableDipal Arora
 
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...CALL GIRLS
 
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...Dipal Arora
 
Call Girls Ooty Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ooty Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Ooty Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ooty Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...
(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...
(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...Taniya Sharma
 
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...hotbabesbook
 
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...aartirawatdelhi
 

Dernier (20)

VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
 
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
 
Call Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service Available
 
Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...
Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...
Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...
 
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
 
Lucknow Call girls - 8800925952 - 24x7 service with hotel room
Lucknow Call girls - 8800925952 - 24x7 service with hotel roomLucknow Call girls - 8800925952 - 24x7 service with hotel room
Lucknow Call girls - 8800925952 - 24x7 service with hotel room
 
Book Paid Powai Call Girls Mumbai 𖠋 9930245274 𖠋Low Budget Full Independent H...
Book Paid Powai Call Girls Mumbai 𖠋 9930245274 𖠋Low Budget Full Independent H...Book Paid Powai Call Girls Mumbai 𖠋 9930245274 𖠋Low Budget Full Independent H...
Book Paid Powai Call Girls Mumbai 𖠋 9930245274 𖠋Low Budget Full Independent H...
 
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any TimeTop Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
 
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service Available
 
Chandrapur Call girls 8617370543 Provides all area service COD available
Chandrapur Call girls 8617370543 Provides all area service COD availableChandrapur Call girls 8617370543 Provides all area service COD available
Chandrapur Call girls 8617370543 Provides all area service COD available
 
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...
 
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
 
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
 
Call Girls Ooty Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ooty Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Ooty Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ooty Just Call 9907093804 Top Class Call Girl Service Available
 
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
 
(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...
(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...
(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...
 
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
 
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service Available
 
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
 
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
 

Cmp new information session ppt

  • 1. DOCTORS CARE PROGRAM GROUP INFORMATION SESSION New and Returning Applicants 2012
  • 2. AGENDA 1. Introduction 2. Paperwork in Packet 3. Percentage Payments 4. PCPs & Specialists 5. Hospital Services 6. Prescriptions & Supplies 7. On-Site Services 8. Renewal 9. Frequently Asked Questions (FAQ) 10. Last Reminders 11. Next Steps 12. Set up Appointment
  • 3. AGENDA 1. Introduction 2. Paperwork in Packet 3. Percentage Payments 4. PCPs & Specialists 5. Hospital Services 6. Prescriptions & Supplies 7. On-Site Services 8. Renewal 9. Frequently Asked Questions (FAQ) 10. Last Reminders 11. Next Steps 12. Set up Appointment
  • 4. INTRODUCTION Welcome to Doctors Care! 1. Why are you here? 2. My goal today… 3. You need to… 4. Today’s session will… 5. Our next step after today’s session…
  • 5. WHO WE ARE  Background:  Doctors Care was started by the Arapahoe Medical Society in 1988.  This program is supported by hospitals and physicians volunteering their time and services for medically underserved patients.  Our goal is to allow everyone on the program to have access to complete health care.  However, because we rely on community physicians volunteering their time, sometimes we do have a wait list for primary care and specialties. We do our best to move patients off the wait list as quickly as possible.
  • 6. WHAT WE’RE NOT  We are not insurance  Physicians & hospitals do not receive any payment from us  You do not pay a monthly or yearly amount in order to use our services.  We are not a long term program.  Each patient over 18 has a maximum of two years of coverage in his or her lifetime.
  • 7. ARE YOU ELIGIBLE? 1. Do you have any kind of health insurance?  We do not provide care for those who already have health coverage, even if it is minimal or unaffordable coverage  That includes CICP, Medicaid, Medicare, MCPN, etc. 2. Do you live in our service area?  We only serve patients living in Douglas, Elbert, or Arapahoe counties excluding the city of Aurora. 3. Do you have a medical concern?  We do not provide any physicals and preventative care for adults, b ut there are other programs that do.  Asking your PCP for physicals and preventative care can result in termination from the program.  This program is not intended for backdating purposes only. Therefore to qualify for this program you must have a need for ongoing medical care.
  • 8. BACKDATING  Once you come on the program we do provide a 90 day backdating service.  Any bills from our partner hospitals can be backdated up to three months.  This service will not count against your two years on the program.  Just remember to bring any bills you have as well as any receipts for payments to your next appointment.  NOTE: If you haven’t received the bills yet, please don’t wait to make an appointment for your individual financial review. Sometimes those bills can take a while to come through, and you might pass your 90 day limit before they arrive. They are not required for eligibility.
  • 9. AGENDA 1. Introduction 2. Paperwork in Packet 3. Percentage Payments 4. PCPs & Specialists 5. Hospital Services 6. Prescriptions & Supplies 7. On-Site Services 8. Renewal 9. Frequently Asked Questions (FAQ) 10. Last Reminders 11. Next Steps 12. Set up Appointment
  • 10. PAPERWORK IN PACKET  Patient Guidelines  Contract for Participation  HIPAA Release of Information  Authorization for use and disclosure of PHI  How are you Feeling?  Medical History  PCP Acknowledgment for Mental Health  Additional Packet info  Request for resources  Thank you!  CT/MRI  Staff business cards  GIS Survey
  • 11. REQUIRED PAPERWORK  Don’t worry- you will have time after the presentation to fill these out and ask questions!  Nothing is required today.  If you have your paper work with you today, please just place it in the purple folder we have given you and bring it back with you when you come in for your Individual Financial Intake appointment.  If you have any questions about the financial paperwork you brought in today, feel free to ask questions after the presentation.
  • 12. PATIENT GUIDELINES  This is a detailed outline of all rules that must be followed during your time on Doctors Care.  Keep these guidelines and refer to them when you have questions.  Read through at home and ask questions at your next meeting
  • 13. CONTRACT FOR PARTICIPATION  Each adult applying for the program will need to fill out a Contract for Participation.  Please initial each line and sign & date the form.  You will be held accountable to this form!  Please be sure that you understand everything BEFORE signing.  We will copy this form so that you may also keep a copy for your records.
  • 14. HIPAA RELEASE OF INFORMATION  Each family member must have a HIPAA form on file to be covered.  Parent or guardian must fill out for each child under the age of 18.  We also require that you not line through the options for sharing drug, alcohol, and psychological information to be part of the Doctors Care program.  If you have concerns regarding this, please wait and speak with me individually after the session. You can decide whether or not to sign at that time.
  • 15. Authorization for use and disclosure of PHI  If you would like Doctors Care the option of leaving messages on any voicemail, please indicate so, otherwise we will leave a generic message that we have called.  If you would like other individuals to have access to your health information, please indicate so on the form, without your consent, Doctors Care will not be able to release any information to anyone other than yourself.
  • 16. HOW ARE YOU FEELING TODAY?  This is not just a polite question- it’s another form we need you to fill out.  Please answer honestly: these results are kept confidential.  Each adult applying for coverage needs to fill out this form at intake and for every renewal.  You may skip the final two questions on the back at this time unless you have been part of Doctors Care previously.
  • 17. MEDICAL HISTORY  Your application includes a brief medical history form. Must be completely filled out.  Please take one of these for each adult applying for coverage.
  • 18. ADDITIONAL PACKET INFORMATION  Request for Resources  If you are interested in any of the resources listed on this page, please fill out and turn in today or return at your financial screening.  A Doctors Care volunteer will contact you regarding community resources available in your areas of need.  “Thank You!”  “CT/MRI Scans”  Staff business cards  GIS survey
  • 19. AGENDA 1. Introduction 2. Paperwork in Packet 3. Percentage Payments 4. PCPs & Specialists 5. Hospital Services 6. Prescriptions & Supplies 7. On-Site Services 8. Renewal 9. Frequently Asked Questions (FAQ) 10. Last Reminders 11. Next Steps 12. Set up Appointment
  • 20. COST OF SERVICES  You are responsible for the percentage payment listed on your card.  This is determined by a sliding fee scale based on your individual financial situation.  Example: An MRI costs $1000 and your percentage payment is 20%. You pay $200, and the doctor’s office donates $800 to cover the remaining cost.  You must pay your entire percentage payment at the time of service.  If you know you will be unable to pay the full amount at the time of service, you must make a payment plan with the provider before your appointment.
  • 21. PERCENTAGE PAYMENT PLANS  You will be assigned to one of the following plans: Plan Percent Physician Lab/ Outpatient Inpatient Pharmacy Payment Radiology Hospital Hospital % A 5% 5% 5% 5% 5% $10 B 10% 10% 10% 5% 5% $10 C 20% 20% 20% 10% 5% $10 D 30% 30% 10% 10% 10% $15 E 50% 50% 20% 20% 10% $15 F 75% 75% 20% 20% 10% $15  This will be described in greater detail at your next meeting, and you’ll be given a comprehensive benefit plan for your individual situation.
  • 22. FIRST IMPORTANT RULE 1. Pay your percentage payments
  • 23. PAY YOUR PERCENTAGE PAYMENTS  If you fail to provide your Percentage payment at the time of service you will not be able to keep your appointment and it will be recorded as a no-show.  Repeated failures to provide your payment at the time of service will result in termination from the program.  If you fail to pay on your arranged payment plan on time, you may be terminated from the program and/or sent to a collections agency.  Any bill which is turned over to a collection agency will have the discount reversed (you will be sent to collections for 100% of the cost) and you will be immediately terminated from the program.
  • 24. AGENDA 1. Introduction 2. Paperwork in Packet 3. Percentage Payments 4. PCPs & Specialists 5. Hospital Services 6. Prescriptions & Supplies 7. On-Site Services 8. Renewal 9. Frequently Asked Questions (FAQ) 10. Last Reminders 11. Next Steps 12. Set up Appointment
  • 25. YOUR PRIMARY CARE PHYSICIAN  Every person on the Doctors Care program must be assigned to a Primary Care Provider(PCP).  Patients 30 years or younger will be assigned to the Doctors Care Clinic.  Patients over 30 years will be assigned to a participating provider in the community.  If you are established with a provider not in our network, you may choose to be assigned to an “Out of Network” physician, but you will be responsible for all charges with that provider.  The PCP’s office will serve as your Medical Home.  They will house your medical records.  You will use this physician for medical care and specialist referrals.
  • 26. FIRST APPOINTMENT  You must set up an initial appointment with your PCP during your first month of eligibility.  Failing to do so indicates that you aren’t in need of medical coverage and will result in termination from the program.  Let them know you are on the Doctors Care program when you call to make your appointment.  Be prepared to bring your card and your percentage payment for every appointment.  Start gathering your medical history paperwork now to speed up the process with your new PCP.
  • 27. LIMITATIONS WITH PROVIDERS  Your doctor (PCP or otherwise) is not required to fill out any paperwork or forms unrelated to Doctors Care. In addition physicals are not covered by Doctors Care and can be obtained through other resources in the community.  That includes any forms for Social Security, Disability, or Worker’s Compensation.  These may contain phrases like “how long can you sit in a chair” or “how many pounds can you comfortably lift” etc.  Telling a provider to add to or change what he/she wrote down is also inappropriate and is grounds for termination from Doctors Care. If you have a form and wonder whether or not a doctor will fill it out, please give Char a call.
  • 28. SPECIALIST REFERRALS  All specialist referrals must be made through the Doctors Care office.  Have your referring physician call, fax, or email Char the information and she will notify you of the specialist’s name and phone number when the referral is complete.  Doctors Care has over 95 different specialties within our network, so almost everything can be covered.  Not all physicians, their services or facilities in the area are covered under Doctors Care.  You could be held responsible for these charges if you don’t obtain a proper referral.  Some specialists are in high demand, and there may be a wait list to be seen.  We will let you know if this is the case and talk through your options at that time.
  • 29. ALTERNATIVE MEDICINE  Doctors Care also has many alternative medicine providers such as:  Acupuncture  Chiropractic  Massage Therapy  Yoga Therapy  You may self-refer if you are interested in receiving alternative treatment. Simply call Char and she will set it up for you.
  • 30. THREE MORE IMPORTANT RULES 1. Pay your percentage payments 2. Be respectful 3. Show up for appointments 4. Follow through with treatment recommendations
  • 31. BE RESPECTFUL  All of our providers are volunteers, so there is a strong expectation that all physicians and their staff members will be treated with courtesy and respect.  Lack of respect by our members harms our relationships with these providers, and they may not wish to see future patients.  Because this is a chance we’re not willing to take, lack of respect is grounds for termination.  If you have an issue or concern regarding one of our providers or their staff, please call us so that we may mediate on your behalf.
  • 32. SHOW UP FOR APPOINTMENTS  You are responsible for scheduling all of your own appointments.  If you cannot keep an appointment, you must call to cancel within a minimum of 24-48 hours ahead of time. Not doing so is equivalent to not showing up at all.  Three or more no-shows for a PCP will result in termination from the program.  One no-show for a specialist visit is grounds for termination.
  • 33. FOLLOW THROUGH ON REFERRALS  Not following through on referrals from your provider is also considered a lack of respect.  If you have an issue or concern regarding the treatment recommendations, please call the Patient Care Coordinator and ask if she can set up an appointment to get a second opinion.
  • 34. AGENDA 1. Introduction 2. Paperwork in Packet 3. Percentage Payments 4. PCPs & Specialists 5. Hospital Services 6. Prescriptions & Supplies 7. On-Site Services 8. Renewal 9. Frequently Asked Questions (FAQ) 10. Last Reminders 11. Next Steps 12. Set up Appointment
  • 35. HOSPITALIZATION  Doctors Care partners with five hospitals:  Swedish Medical Center  Porter Adventist Hospital  Littleton Adventist Hospital  Sky Ridge Medical Center  Parker Adventist Hospital  Castle Rock Adventist (pending)  You will be assigned to one of these hospitals, and must use only that hospital for all inpatient or outpatient treatments, pharmacy, lab, x-ray, etc, unless it has been pre- authorized by Doctors Care.  Check in at the registration desk before your appointment and the staff will tell you where to go.  Please be prepared to present your card and pay your entire percentage payment at the time of service for any planned procedures.  If you need to arrange a payment plan, you will probably be required to pay at
  • 36. HOW HOSPITAL BILLS WORK  Any procedure done at the hospital will result in at least two bills: 1. Hospital 2. Doctor who interprets the test or procedure  Other bills you may receive in addition to the hospital bill could be for:  The doctor who performs the procedure  Anesthesiology  Radiology  Pathology  Etc.
  • 37. RADIOLOGY  X-rays and other radiology services need to be performed at your assigned hospital.  Your physician will send over the request to the hospital and assist you in scheduling if needed. (Some services are walk-in.)  Remember to check in at registration!  NOTE: For inpatient hospital services, you will be responsible for both the percentage payment for the hospital that performs the service as well as the physician who reads your films.  The physician bill will likely come in the mail from Radiology Imaging Associates or Diversified Radiology.  This bill should be automatically adjusted to your percentage amount. If it is not, please call them immediately to let them know of your Doctors Care status so that it can be changed.
  • 38. CT AND MRI SCANS  Doctors Care has a special arrangement with one of our radiology partners to provide an option when scheduling CT and MRI scans.  These are performed for the physician’s payment percentage rate instead of the hospital’s rate.  Depending on which plan you’re on, this could mean your CT or MRI scan will be a fraction of the cost of having it done in the hospital.  These appointments must be scheduled through the Patient Care Coordinator, Char.  These appointments are subject to availability.  Have your physician contact her to get this set up instead of contacting the hospital directly.
  • 39. LAB TESTS  Any lab tests like blood work must be completed at your assigned hospital’s lab.  Don’t allow your doctor’s office to draw blood.  You will be responsible for 100% of anything that is drawn at the physician’s office.  We don’t work with Quest or LabCorp, so be sure not to use them!  Have your physician give you a written prescription or call in the order to the hospital laboratory.  Check in at hospital registration with your Doctors Care card, and the staff will direct you to the lab.  Be sure to only use the hospital-run lab.
  • 40. ANESTHESIOLOGY  Doctors Care partners with:  Guardian Anesthesia  South Denver Anesthesiologists  Colorado Anesthesia Consultants  OB/GYN Anesthesiologists.  Those groups are listed in your guidelines.  Any services performed by one of these groups will be covered under Doctors Care.
  • 41. ANESTHESIOLOGY  They are the primary groups that work with our hospitals and doctors, but are not the only anesthesia groups in the South Metro area.  If you are planning a surgery, please request that your doctor use one of these groups.  If you receive a bill from them that does not appear to be adjusted to your percentage payment, please contact their billing office right away to inform them of your Doctors Care participation.
  • 42. EMERGENCY ROOM  Emergency room visits are expensive and designed for true emergencies only.  If you use the emergency room, the hospital portion of your bill will be covered, however the ER physician cost will be completely your responsibility.  While we have informal agreements with certain ambulance providers, this is not an official covered benefit, and you may be responsible for 100% of this cost as well.  Please contact Char if you receive an ambulance bill to determine if there may be a way to have it reduced.
  • 43. ABUSE OF THE EMERGENCY ROOM  Using the emergency room for inappropriate reasons is grounds for termination from the Doctors Care program.  Doctors Care receives monthly reports from the hospitals of our patients who use the ER.  Inappropriate uses include (but are not limited to):  Sore throat  Sinus infection  Diaper rash  Obtaining pain or refill medication
  • 44. HOW TO USE THE ER If you feel you have a situation that can’t wait until the physician office opens but is not life- threatening: 1. Call your doctor’s office and follow the advice given by the after-hours provider.  If you are told to go to the ER by this provider, it will not be considered abuse, and you should follow all instructions given. 2. If you do go to the ER, call Doctors Care as soon as possible afterwards.  This will let us know that you were not trying to abuse
  • 45. URGENT CARE IS AN OPTION  As another option for after-hours care, Doctors Care partners with Doctors Express, an urgent care clinic that is open 8 a.m. to 8 p.m. , 365 days a year.  Please still call your PCP before accessing urgent care.  This is a much cheaper option than using the Emergency Room, and they will also see you with less of a wait time.  901 W. Hampden Ave.  Englewood, CO 80110  (303) 761-1699  $25 for Plans A, B and C  $50 for Plans D, E and F
  • 46. AGENDA 1. Introduction 2. Paperwork in Packet 3. Percentage Payments 4. PCPs & Specialists 5. Hospital Services 6. Prescriptions & Supplies 7. On-Site Services 8. Renewal 9. Frequently Asked Questions (FAQ) 10. Last Reminders 11. Next Steps 12. Set up Appointment
  • 47. PRESCRIPTIONS  Prescriptions are only filled when written by a participating provider.  If you are using an out-of-network provider, contact Char to see if you can get special authorization for your prescription.  Prescriptions covered by Doctors Care can only be filled at your assigned hospital’s outpatient pharmacy.  See list in the Patient Guidelines  Only generic prescriptions are covered.  If your provider needs you to be on a prescription with no generic substitutes, have them call Char to see if it can be specially authorized.  Please allow 24 hours for any refills.  This will allow the pharmacy time to call the physician for approval if needed.
  • 48. PRESCRIPTION COSTS  Your prescription cost depends on your percentage payment.  Plans A, B and C: $10 pharmacy co-pay; Plans D, E and F: $15.  This payment covers a one-month supply or one package size.  Example: One inhaler or one vial of insulin  There is a very small possibility that the pharmacy will not stock your prescription. It can’t be special ordered and you will have to go to a retail pharmacy to pay full price.  King Soopers, Target, and Wal-Mart all have certain generic prescriptions available for $4.  This is NOT associated with Doctors Care and not all generics are on this list.  Feel free to call other places to see if their retail price is less than your Doctors Care co-pay.  If you do so, DO NOT present your Doctors Care card, as it is not accepted at these locations.
  • 49. DIABETIC SUPPLIES  Needles for diabetics will be covered in one-month increments.  One co-pay will cover 50 needles.  Doctors Care will cover 50 generic test strips per co-pay.  You may have to buy the generic meter that works with the generic strips carried in your pharmacy, usually between $15-$20.  If you want to use brand name test strips, you’ll have to pay full price.  Brand name insulin will need to be obtained through the drug manufacturer’s Patient Assistance Plan.  Doctors Care will cover your first two months at one co-pay per vial while you are getting signed up. There will not be any extensions.  Contact Char if you need help obtaining the paperwork or filling out the forms for this program.  Start filling out this paperwork as soon as you know you will need insulin. It can take up to two months for the paperwork to be processed.
  • 50. SUPPLIES NOT COVERED  Over-the-counter drugs  Nicotine replacement therapy  Any supplies that can be  Acne therapy for anyone over purchased 18 without a prescription  Mental health medications  Birth control medications  Medical supplies  If this is being prescribed for non- o Examples: contraceptive uses, have your oxygen, wheelchair, hardware, etc. provider contact Char for authorization  Appetite suppressants  Weight loss drugs  Erectile dysfunction medications Most of these supplies are available for free or discounted prices through other services in our community. Please mark the “Request for Resources” page for contact information.
  • 51. SERVICES NOT COVERED  Glasses/Optical care  Dental  Elective care  Adult physicals/preventive care Please contact us if you need help with anything not covered by Doctors Care, as we often know of community resources to help with these needs.
  • 52. SUBSTANCE ABUSE & DEPENDENCE  Doctors Care screens and diagnoses for signs and symptoms of drug and alcohol dependence and abuse.  We will refer clients, when indicated, to community resources equipped to treat dependence and abuse.  Doctors Care mental health providers will continue to counsel and support clients to encourage them to stay engaged in appropriate treatment facilities or other community programs.  Doctors Care is not equipped to provide drug or alcohol treatment or to detox to anyone.  However, if it’s determined that you have dependence or abuse issues, you may be required to follow through on a referral to a treatment program outside of Doctors Care to remain eligible for the program.
  • 53. AGENDA 1. Introduction 2. Paperwork in Packet 3. Percentage Payments 4. PCPs & Specialists 5. Hospital Services 6. Prescriptions & Supplies 7. On-Site Services 8. Renewal 9. Frequently Asked Questions (FAQ) 10. Last Reminders 11. Next Steps 12. Set up Appointment
  • 54. THE DOCTORS CARE CLINIC  For children and young adults up to age 30, the clinic provides appointments for most illnesses and injuries.  Percentage payments for an office visit are listed in your guidelines.  Office hours: M-TR 9am-5pm and F 9am-4pm.  Please call to set up an appointment.  Walk-ins are not accepted.  Same day appointments are generally available if needed.  Annual physicals for ages 3-18: regular co-pay + lab costs.  Children under 3 may need to be seen more frequently for check-ups and immunizations. These visits are covered for regular co-pay plus lab costs.
  • 55. MENTAL HEALTH  We currently have one therapist and one psychiatric mid-level provider on site for mental health counseling appointments and medication management, as well as many off-site counselors.  You may self-refer or your PCP may refer for mental health appointments.  Contact Char to set up mental health appointments.  Our mental health professionals will be available to provide counseling or therapy.  We do have resources here at Doctors Care that we can use so you can obtain Mental Health medications for low cost.
  • 56. MENTAL HEALTH APPOINTMENTS Plan On-site Mental Remember to contact Char if you Health Visit would like to get an appointment A $10 set up. B $15 Counselors off-site may have C $15 different pricing structures, but D $20 are also available outside regular E $30 office hours. F $30
  • 57. AGENDA 1. Introduction 2. Paperwork in Packet 3. Percentage Payments 4. PCPs & Specialists 5. Hospital Services 6. Prescriptions & Supplies 7. On-Site Services 8. Renewal 9. Frequently Asked Questions (FAQ) 10. Last Reminders 11. Next Steps 12. Set up Appointment
  • 58. PROGRAM RENEWAL  Your first card will expire in 90 days. This is a probationary period to ensure proper usage of the Doctors Care program.  You will automatically receive a new card about one week prior to this 90-day period for an additional 90 days, assuming there have been no concerns.  You will need to renew your Doctors Care card every six months by resubmitting the renewal application and financial documents. Please make sure theses documents are filled out thoroughly.  A packet containing all required paperwork will be mailed to you approximately one month before each six month expiration.  If for any reason this packet does not arrive, please contact our office to request that we send another one or to arrange pick-up at the office.  If you lose your card, you will be charged $1 for a replacement card.
  • 59. AT YOUR RENEWAL  If you do not need Doctors Care anymore at the time of your renewal, please let us know.  Doing so will allow others in need to use the services provided by our partners.  You will also be granted the opportunity for backdating up to 90 days again should you need to reapply in the future.  Failing to inform us of your decision to quit Doctors Care will result in a loss of the ability to backdate your care in the future.
  • 60. RENEWAL PROCESS  You will not need to come in for an appointment for your renewal. Simply drop off or mail your paperwork.  Your documents will be processed by eligibility counselors and the new card(s) sent by mail.  We do need you to re-submit all financial documents, even if your situation has not changed.  If you do not submit your paperwork by your expiration date, you will automatically be discontinued from the program.  You will be eligible to reapply, but will have to restart the application process.  There is no guarantee that you will be able to stay with the same physicians if this happens, as your spot will quickly be given to another patient in need.
  • 61. AGENDA 1. Introduction 2. Paperwork in Packet 3. Percentage Payments 4. PCPs & Specialists 5. Hospital Services 6. Prescriptions & Supplies 7. On-Site Services 8. Renewal 9. Frequently Asked Questions (FAQ) 10. Last Reminders 11. Next Steps 12. Set up Appointment
  • 62. FREQUENTLY ASKED QUESTIONS  What should I do if I get a bill in the mail that is not adjusted to my percentage payment amount?  First call the billing office as SOON as you receive the bill to inform them of your Doctors Care status and payment level.  If this does not resolve the issue, contact Char and she will work to get the bill appropriately adjusted.  What happens if I accidentally use a provider, lab, or pharmacy outside of the network?  Unfortunately, we are not able to provide assistance for any services incurred outside of our network.  However, most companies will provide some level of discount and/or payment plan for individuals without insurance.
  • 63. SERVICES  Is there anywhere I can go to get my yearly mammogram or well-woman exam?  Tri-county Health Department offers these for low cost. Please request the contact information in your “request for resources” form.  In addition, Doctors Care has been given a grant for free screening mammograms for any woman over 40 who does not have insurance. Ask at the front desk for an application and voucher.  I have been told I should get a colonoscopy screening every year. Is that covered?  Routine screenings (suggested for everyone over 50) are not covered, but are offered for free by the Colorado Colorectal Screening Program.  Screenings required because of a medical concern are covered and will need a referral like any other specialist.
  • 64. THE WAIT LIST  If I am placed on the wait list for a physician, how long will I have to wait?  There is no way for us to know how long you may have to wait.  All our staff are committed to increasing our network of providers to hopefully eliminate the wait list altogether.  We can tell you how many people are ahead of you on the wait list.  Historically, the wait list for a PCP has moved relatively quickly. However, specialist waitlists are very unpredictable.  What if my condition is urgent and I cannot wait?  Our wait list is strictly first come, first serve. There is no way for a person to jump to the “head of the line.”  If you or your doctor feel you cannot wait, you have the option at any time to see a community provider as a self-pay patient.  If you choose to see a provider as a self-pay patient, you may still utilize the hospital, lab, radiology, and possibly pharmacy services through Doctors Care.
  • 65. AGENDA 1. Introduction 2. Paperwork in Packet 3. Percentage Payments 4. PCPs & Specialists 5. Hospital Services 6. Prescriptions & Supplies 7. On-Site Services 8. Renewal 9. Frequently Asked Questions (FAQ) 10. Last Reminders 11. Next Steps 12. Set up Appointment
  • 66. WHEN TO CONTACT US  Please notify Doctors Care within ten days of any change in :  Address  Phone number  Financial or job situation  Insurance status  Family status  Feel free to call the Patient Care Coordinator, Char, with any questions or concerns.  If you ever have any issue with one of our providers or their staff, please contact us to mediate the situation.  If you would ever like a second opinion from a specialist, please contact Char to get it set up.
  • 67. LAST IMPORTANT RULE 1. Pay your percentage payments 2. Be respectful 3. Show up for appointments 4. Follow through with treatment recommendations 5. Communicate
  • 68. COMMUNICATE Communicate, communicate, communicate!  Follow up on bills as soon as you receive them to make a payment plan or adjust the bill to your percentage payment amount.  If you need to use the ER, call your PCP’s after-hours physician and follow their advice FIRST.  If you do use the ER, please call us as soon as you can afterwards and let us know the situation. If you have ANY questions, please call Char.  We understand that there are a lot of rules to remember. We are keeping you accountable to those rules, so please contact us to ask questions rather than possibly making a mistake.
  • 69. AGENDA 1. Introduction 2. Paperwork in Packet 3. Percentage Payments 4. PCPs & Specialists 5. Hospital Services 6. Prescriptions & Supplies 7. On-Site Services 8. Renewal 9. Frequently Asked Questions (FAQ) 10. Last Reminders 11. Next Steps 12. Set up Appointment
  • 70. FINANCIAL INTAKE  Bring ALL documents and paperwork to your next appointment!  We can’t process your application until we have all requested documents listed in your application as well as the paperwork you received today.  NOTE: Remember that hospital bills are not required for this appointment, but do bring them if you have them.  If you have all required documentation, you will either be assigned to a physician or placed on the wait list at the time of your financial screening.  If you are placed on the wait list, you will be called as soon as a spot opens up.  You will have 48 hours to verify that you want the slot or it will be given to someone else and you will be moved to the bottom of the wait list.
  • 71. EXTRA PAPERWORK  Additional forms are needed if you are:  Self-employed  Living with a friend or family member (not on a lease)  Signing up additional adults  Signing up children  You may also need a medical history form if you haven’t filled one out.
  • 72. WHAT DO I NEED TO TURN IN TODAY?  Nothing is required today.  Please remember there is additional information in your purple packet that you will need to read over, fill out, and bring with you when you attend your financial intake appointment.  If you have any questions about the financial paperwork you brought in today, feel free to ask questions after the presentation.
  • 73. 5 RULES TO REMEMBER 1. Pay your percentage payments 2. Be respectful 3. Show up for appointments 4. Follow through with treatment recommendations 5. Communicate
  • 74. CONCLUSION Thank you for coming today! 1. My goal today was to teach you how Doctors Care works and what your role will be in our program. 2. You need to follow our rules and regulations to be part of the program, and we’re here to help you along the way. 3. Our next step is to schedule a Financial Intake appointment.
  • 75. AGENDA 1. Introduction 2. Paperwork in Packet 3. Percentage Payments 4. PCPs & Specialists 5. Hospital Services 6. Prescriptions & Supplies 7. On-Site Services 8. Renewal 9. Frequently Asked Questions (FAQ) 10. Last Reminders 11. Next Steps 12. Set up Appointment
  • 76. MAKE AN APPOINTMENT  Appointment cards for your financial screening meeting are at the end of the table.  There are two cards in each pile, both with the same time and date. 1. Card one: Write your name and phone number and turn in today so I can put you in our calendar. 2. Card two: Keep it for yourself as a reminder!

Notes de l'éditeur

  1. You are all here today because you or one of your family members has a medical concern without health insurance, and are reaching out to Doctors Care for help.My goal today is to teach you how Doctors Care works and what your role will be in our program. You need to follow our rules and regulations to be part of the program, and we’re here to help you along the way.Today’s session will help you know how Doctors Care works and what your next steps are.Our next step after today’s session is to schedule a Financial Intake Meeting and give you the tools to get you started on our program.