1. Riding the Enrollment Assistance Roller Coaster
With
Joanne Hermiston
&
Melissa Bell
Index Card: As guests enter have them fill out an index card and share a challenge or success. Use later on in lessons learned.

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

3. Where do you stand???
If you or your organization has participated in one way or another please stand up.
Have people set down for each year starting with last years enrollment as the 1st year.
Reminder: Fill out index card…
a. any successes
b. overcome challenges
3) Introduce remaining experts. (Broad comment about those that remain standing.)

4. Why is ACA enrollment important?
Some who benefit from it are…
Patients
Staff
Clinic
Community
More details in following slides…

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

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

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

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

9. What’s involved??? Certification process for clinic organization (CDO)
Internal clinic workflow processes
Materials
Identifying eligible individuals
Appointment screening & scheduling
Assistance & education
Tracking & reporting
With open enrollment starting 11/1/2016, enough time needs to be allowed to complete the CMS training.
Processes:
Materials needed & ready
Identifying eligible individuals - inbound & outbound
Appointment screening & scheduling process
Assistance/education with selection process
Tracking & reporting

10. What’s involved??? Individual CAC Certification process
Signed CAC agreement with CDO
Training courses through CMS for CAC’s
7 required modules (2017) & 5-10 hours to complete
CDO issues an official CAC certificate
Open enrollment begins November 1st, 2016
With open enrollment starting 11/1/2016, enough time needs to be allowed to complete the CMS training.
Processes:
Materials needed & ready
Identifying eligible individuals - inbound & outbound
Appointment screening & scheduling process
Assistance/education with selection process
Tracking & reporting – NEXT SLIDE more details….

11. Monitoring Progress Tracking & Reporting:
Quarterly Dashboard Report (clinic goals)
FPCI & OPA reporting
Other agency reporting
* Consider all factors to determine success!
Other agency reporting:
County Board of Health
County Board of Supervisors
United Way
Consider using for other grants that are agency specific.
Determining Success:
ROI
Patient utilization

12. Avoiding Common Pitfalls
Time
Assistance area considerations
What’s needed for appointments
Helpful tools
Partnerships/Resources
Lessons learned
Time:
Screening calls: 1hr. Appointment vs. 2 hr. Appointment (also to include informing patient)
Multiple appointments – follow up calls or appointments
Assistance area considerations:
1) Computer & phone access
2) Private space - HIPPA
What’s needed for appointments:
Appointments: provider, medications – to make plan selections
Information: employer insurance offered, income, legal status cards, DOB & SSN for all household members, taxes, access (password & username)
Helpful Tools:
CAC handbook for appointments
Blue folder: Coverage to Care (booklets-roadmap) * insurance terminology resource
Scrips: CMS, NFPRHA, others or make your own
NFPRHA: envelopes, bookmarks, enrollment kits
Partnerships/Resources:
Resources: NFPRHA (Get Covered Materials); Coverage to Care books – available free from CMS
Support network: FPCI monthly phone calls
Community Partnerships: Navigators, CAC’s within community
Lessons Learned:
Index cards (challenges & successes): Group discussion, time permitting.
Questions for index card…
a. any successes
b. overcome challenges

13. INCOME GAME Iowa Wellness Plan Marketplace
Iowa Marketplace Choice Plan
Private Broker
Employer Insurance
Insert game here: income levels – what they qualify for…
Use scenarios and distribute one per table. (5-6)

14. Questions...