Medicaid Denials: Following up with Customers

2

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.

4

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

4

Ongoing Process

• Each Tuesday/Thursday, December 2013- March 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

4

Report Format

CASE_IDC4_ACCOUNT_ID SOURCE

DATE_RECEIVED_BY_C4

Household_Contact_Firstname

Household_Contact_Last_Name

EMAIL_ADDRESSPHONE_NUMBER STREET_ADDRESS

ADDRESS_CITY

ADDRESS_STATE

ADDRESS_ZIP

AGENT_FIRST_NAME

AGENT_LAST_NAME

AGENT_EMAIL_ADDRESS

License Number

MEDICAID_CHP_INELIGIBLE_1

DENIAL_REASON_CODE_1

DENIAL_REASON_1

PRIORITY_NUM_1

1B061A8 CBMS 11/18/2013 17:44

Jimmy Smith

report.email@email.com 71948712341234 1st Street BOULDER CO 80301Jimmy Smith MA0209

Ineligible because did not apply 2

1B06CX2 1201234569PEAK 11/18/2013 17:44

Tammy Jones

jones.email@email.com 72055574744321 Monument Avenue DENVER CO 80205

Tammy Jones MA0210

Individual not living in the home 1

1B07GQ4 CBMS 11/18/2013 17:45

Betty Benajamin

betty.email@email.com 97055543215678 Smith Way GREELEY CO 80631

Betty Benajamin MA0208

Countable income above the allowable limit 1

4

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

5

What We Are MessagingView 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 away 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.

6

Need Assistance?

If you are working with an agent/broker or Health Coverage Guide or you want in-person 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 J anuary 1, 2014, if you buy before December 15th, 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

What We Are Messaging (cont.)

6

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!

6

Key Take Aways

• These are your leads!

• Keep Security and Privacy requirements in mind

• December 23rd is the deadline for enrollment

7

Questions?

Question and answer session