Transcript Medicaid Denials Leads Information Session

Medicaid Denials:
Following up with Customers
Goals
• Get your customers enrolled in APTC and a
Plan, by the December deadline!
• Learn when and how your customer
denial/lead reports will come to you
• Learn how Connect for Health Colorado will
be messaging shopping readiness along with
you.
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Key Dates
• November 26th through December 2nd, 2013
• Denial report and lead Information webinars conducted
• December 5th, 2013
• Distribute /lead reports, with “look back” data to 10/1/13
December 5th through December 16th, 2013
• You should enroll your customers! Call, email, visit, hug
December 16th, 2013
• Distribute “newly denied” denial/lead reports
• You should enroll your customers! Call, email, visit….
• December 23th, 2013
• Final day for enrollment to receive coverage on January 1st, 2014
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Ongoing Process
• Each Tuesday/Thursday, December 2013March 2014
• Or… do you want it once per week?
• Develop a secure place to post denial/lead
reports
• Reports provide listing of associated clients
with Priority 1 and Priority 2 denials identified
who have not yet completed enrollment
Priority 1 = C4 Account + Denied + Associated
Priority 2 = C4 Account + NO Denial + Associated
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Report Format
Household_Co
Household_Con
ntact_Last_Na
tact_Firstname
me
CASE_ID
C4_ACCOUNT_
ID
SOURCE
DATE_RECEIVED_B
Y_C4
EMAIL_ADDRESS
Jimmy
1B061A8
CBMS
1B06CX2
1201234569 PEAK
1B07GQ4
CBMS
11/18/2013 17:45
[email protected]
7194871234 1234 1st Street
[email protected]
4321 Monument
7205557474 Avenue
BOULDER
CO
80301
Jimmy
Smith
80205
Tammy
Jones
MA0209
Ineligible
because
did not
apply
2
MA0210
Individual
not living in
the home
1
Countable
income
above the
allowable
limit
1
Jones
11/18/2013 17:44
Betty
MEDICAID DENIAL_R
_CHP_INE EASON_C DENIAL_R PRIORITY_
LIGIBLE_1 ODE_1
EASON_1 NUM_1
Smith
11/18/2013 17:44
Tammy
AGENT_FI
AGENT_E
PHONE_NUMBE
ADDRESS_C ADDRESS ADDRESS RST_NAM AGENT_LA MAIL_ADD License
R
STREET_ADDRESS ITY
_STATE
_ZIP
E
ST_NAME RESS
Number
DENVER
CO
Benajamin
[email protected]
9705554321 5678 Smith Way
4
GREELEY
CO
80631
Betty
Benajamin MA0208
Customer and C4HCO Messaging Schedule
• Connect for Health Co. is also reaching out!
• November 5th, 2013
• 1st Outbound Enrollment Messaging campaign began
• First round of e-mails and letters distributed to customers with a
Medicaid denial
• November 19th and 21st, 2013
• Initiated weekly Tuesday/Thursday e-mail and letter distribution
schedule to customers, with a Medicaid denial
• November 26th through December 23rd, 2013
• Continue Tuesday/Thursday e-mail and letter distribution
campaign
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What We Are Messaging
View this message in your browser
November 21st, 2013
Dear ,
Thank you for your interest in purchasing health insurance through Connect for
Health Colorado. We are pleased to inform you that you are ready for the next
steps in the process of applying for financial assistance to reduce your costs and
enroll. So, welcome back and let's get started in completing your purchase of health
insurance through our site!
We have been informed that the State has determined that you [and one or more
of your family members] are not eligible for Medicaid and/or CHP+. This decision
means you may be eligible for financial assistance through Connect for Health
Colorado and we want to help.
Please visit Connect for Health Colorado at:
https://prd.connectforhealthco.com/individual to continue with your application. If
you are working with a Broker or a Health Coverage Guide, you should ask for their
help, too. You may qualify for new financial assistance that you can use right a way
to reduce the cost of monthly payments and out-of-pocket expenses when you
purchase private insurance, only available through our marketplace. When online,
follow these 4 steps:
· Create or Login to your Connect for Health Colorado Account
· Select "Complete Eligibility" (Blue button located in your Account
Overview)
· Enter your CBMS Denial Case Number.
· Tip: this number begins with '1B' and can be found in the - letter you
received from the State. You can find this number by logging into your
PEAK account (if created) or by calling 1-800-359-1991.
· Tip: be sure to type in this number EXACTLY as it is (using capitals, etc)
don't cut and paste-type it directly, please.
· Complete the financial assistance application for Connect for Health
Colorado.
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What We Are Messaging (cont.)
Need Assistance?
If you are working with an agent/broker or Health Coverage Guide or you want inperson assistance, you can continue to work with them or find someone through
the following directory and set up an appointment:
https://prd.connectforhealthco.com/individual/broker
https://prd.connectforhealthco.com/individual/navigator_entity_admin
You can also work with our Customer Service Center to complete your application
by calling 1-855-306-7338 (TTY: 1-855-346-3432), 7 a.m. to 8 p.m. Monday to
Saturday. When you call, mention that you have received a denial for Medicaid and
CHP+ and you are ready to complete your application. Make sure you have your
CBMS Denial Case ID ready.
Time to Enroll in Your Health Plan!
Open enrollment lasts from October 1, 2013 - March 31, 2014, so it is important
that you choose your health plan before then. Your healthcare coverage will begin
January 1, 2014, if you buy before December 15 th, 2013.
Thanks for allowing us to help you with your coverage needs,
Connect for Health Colorado
You can get this letter in Spanish or in a large print copy or another way that's best
for you. Call 1-855-PLANS 4 YOU (752-6749) (TTY: 1-855-346-3432). Puede recibir
esta carta en copia impresa con letra grande o de cualquier otra manera que le
resulte conveniente.
Llame al 1-855-PLANS 4 YOU (752-6749) (TTY: 1-855-346-3432).
Connect for Health Colorado is a new health insurance marketplace and support
network that allows individuals, families and small employers to compare and
purchase health insurance and access new financial assistance to reduce costs.
Learn more at www.connectforhealthco.com.
Connect for Health Colorado
P.O. Box 35681 • Colorado Springs ,CO 80935 • ConnectforHealthCO.com
Unsubscribe
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Follow up Messaging at 5 days
Dear _______,
Connect for Health Colorado has recently begun working
with your <broker>, <health coverage guide>, <carrier
sales rep> to advise them of the decision by Medicaid
that you are NOT eligible for state benefits. This means
you may well be able to get financial help through
Connect for Health Colorado to pay for health insurance.
We are excited to have you shop, compare and enroll!
Please contact your <broker>, <health coverage guide>,
<carrier sales rep>to complete this purchase and thank
you!
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Key Take Aways
• These are your leads!
• Keep Security and Privacy requirements in
mind
• December 23rd is the deadline for enrollment
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Questions?
Question and answer session
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