Cmp new information session ppt

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DC GIS ppt 4-12

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  • 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.
  • Cmp new information session ppt

    1. 1. DOCTORS CARE PROGRAMGROUP INFORMATION SESSION New and Returning Applicants 2012
    2. 2. AGENDA1. Introduction2. Paperwork in Packet3. Percentage Payments4. PCPs & Specialists5. Hospital Services6. Prescriptions & Supplies7. On-Site Services8. Renewal9. Frequently Asked Questions (FAQ)10. Last Reminders11. Next Steps12. Set up Appointment
    3. 3. AGENDA1. Introduction2. Paperwork in Packet3. Percentage Payments4. PCPs & Specialists5. Hospital Services6. Prescriptions & Supplies7. On-Site Services8. Renewal9. Frequently Asked Questions (FAQ)10. Last Reminders11. Next Steps12. Set up Appointment
    4. 4. INTRODUCTIONWelcome 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. 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. 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. 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. 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. 9. AGENDA1. Introduction2. Paperwork in Packet3. Percentage Payments4. PCPs & Specialists5. Hospital Services6. Prescriptions & Supplies7. On-Site Services8. Renewal9. Frequently Asked Questions (FAQ)10. Last Reminders11. Next Steps12. Set up Appointment
    10. 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. 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. 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. 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. 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. 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. 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. 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. 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. 19. AGENDA1. Introduction2. Paperwork in Packet3. Percentage Payments4. PCPs & Specialists5. Hospital Services6. Prescriptions & Supplies7. On-Site Services8. Renewal9. Frequently Asked Questions (FAQ)10. Last Reminders11. Next Steps12. Set up Appointment
    20. 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. 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. 22. FIRST IMPORTANT RULE1. Pay your percentage payments
    23. 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. 24. AGENDA1. Introduction2. Paperwork in Packet3. Percentage Payments4. PCPs & Specialists5. Hospital Services6. Prescriptions & Supplies7. On-Site Services8. Renewal9. Frequently Asked Questions (FAQ)10. Last Reminders11. Next Steps12. Set up Appointment
    25. 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. 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. 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 adoctor will fill it out, please give Char a call.
    28. 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. 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. 30. THREE MORE IMPORTANT RULES1. Pay your percentage payments2. Be respectful3. Show up for appointments4. Follow through with treatment recommendations
    31. 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. 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. 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. 34. AGENDA1. Introduction2. Paperwork in Packet3. Percentage Payments4. PCPs & Specialists5. Hospital Services6. Prescriptions & Supplies7. On-Site Services8. Renewal9. Frequently Asked Questions (FAQ)10. Last Reminders11. Next Steps12. Set up Appointment
    35. 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. 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. 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. 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. 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. 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. 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. 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. 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. 44. HOW TO USE THE ERIf you feel you have a situation that can’t waituntil 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. 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. 46. AGENDA1. Introduction2. Paperwork in Packet3. Percentage Payments4. PCPs & Specialists5. Hospital Services6. Prescriptions & Supplies7. On-Site Services8. Renewal9. Frequently Asked Questions (FAQ)10. Last Reminders11. Next Steps12. Set up Appointment
    47. 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. 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. 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. 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. 51. SERVICES NOT COVERED Glasses/Optical care Dental Elective care Adult physicals/preventive carePlease contact us if you need help withanything not covered by Doctors Care, as weoften know of community resources to helpwith these needs.
    52. 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. 53. AGENDA1. Introduction2. Paperwork in Packet3. Percentage Payments4. PCPs & Specialists5. Hospital Services6. Prescriptions & Supplies7. On-Site Services8. Renewal9. Frequently Asked Questions (FAQ)10. Last Reminders11. Next Steps12. Set up Appointment
    54. 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. 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. 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. 57. AGENDA1. Introduction2. Paperwork in Packet3. Percentage Payments4. PCPs & Specialists5. Hospital Services6. Prescriptions & Supplies7. On-Site Services8. Renewal9. Frequently Asked Questions (FAQ)10. Last Reminders11. Next Steps12. Set up Appointment
    58. 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. 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. 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. 61. AGENDA1. Introduction2. Paperwork in Packet3. Percentage Payments4. PCPs & Specialists5. Hospital Services6. Prescriptions & Supplies7. On-Site Services8. Renewal9. Frequently Asked Questions (FAQ)10. Last Reminders11. Next Steps12. Set up Appointment
    62. 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. 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. 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. 65. AGENDA1. Introduction2. Paperwork in Packet3. Percentage Payments4. PCPs & Specialists5. Hospital Services6. Prescriptions & Supplies7. On-Site Services8. Renewal9. Frequently Asked Questions (FAQ)10. Last Reminders11. Next Steps12. Set up Appointment
    66. 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. 67. LAST IMPORTANT RULE1. Pay your percentage payments2. Be respectful3. Show up for appointments4. Follow through with treatment recommendations5. Communicate
    68. 68. COMMUNICATECommunicate, 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. 69. AGENDA1. Introduction2. Paperwork in Packet3. Percentage Payments4. PCPs & Specialists5. Hospital Services6. Prescriptions & Supplies7. On-Site Services8. Renewal9. Frequently Asked Questions (FAQ)10. Last Reminders11. Next Steps12. Set up Appointment
    70. 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. 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. 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. 73. 5 RULES TO REMEMBER1. Pay your percentage payments2. Be respectful3. Show up for appointments4. Follow through with treatment recommendations5. Communicate
    74. 74. CONCLUSIONThank 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. 75. AGENDA1. Introduction2. Paperwork in Packet3. Percentage Payments4. PCPs & Specialists5. Hospital Services6. Prescriptions & Supplies7. On-Site Services8. Renewal9. Frequently Asked Questions (FAQ)10. Last Reminders11. Next Steps12. Set up Appointment
    76. 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!

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