ohca online enrollment “easy as 1-2-3 for soonercare members and partners” richard evans,...
TRANSCRIPT
![Page 1: OHCA Online Enrollment “Easy as 1-2-3 for SoonerCare members and partners” Richard Evans, Manager, Eligibility Automation and Data Integrity, OHCA](https://reader035.vdocuments.us/reader035/viewer/2022062423/56649f2f5503460f94c48bba/html5/thumbnails/1.jpg)
OHCA Online EnrollmentOHCA Online Enrollment“Easy as 1-2-3 for SoonerCare “Easy as 1-2-3 for SoonerCare
members and partners” members and partners” Richard Evans, Manager,
Eligibility Automation and Data Integrity,
OHCA
![Page 2: OHCA Online Enrollment “Easy as 1-2-3 for SoonerCare members and partners” Richard Evans, Manager, Eligibility Automation and Data Integrity, OHCA](https://reader035.vdocuments.us/reader035/viewer/2022062423/56649f2f5503460f94c48bba/html5/thumbnails/2.jpg)
Online Enrollment Description
• Launch date: September 7, 2010 for www.mySoonerCare.org
• Concept submitted to CMS in summer of 2007. Work began after approval December 2007
Web based Application
Web based Application
Streamlines policy and processes
Streamlines policy and processes
Immediate decision/
information
Immediate decision/
information
![Page 3: OHCA Online Enrollment “Easy as 1-2-3 for SoonerCare members and partners” Richard Evans, Manager, Eligibility Automation and Data Integrity, OHCA](https://reader035.vdocuments.us/reader035/viewer/2022062423/56649f2f5503460f94c48bba/html5/thumbnails/3.jpg)
Why Create This?
• Increase effectiveness and efficiency– Improve client numbering– Streamline enrollment and verification– Intuitive application with editing controls
• Vehicle for multiple program applications Phase I populations
– SoonerCare (Children, Families, Pregnant)– SoonerPlan (Family Planning Waiver)– State Sponsored Behavioral Health
![Page 4: OHCA Online Enrollment “Easy as 1-2-3 for SoonerCare members and partners” Richard Evans, Manager, Eligibility Automation and Data Integrity, OHCA](https://reader035.vdocuments.us/reader035/viewer/2022062423/56649f2f5503460f94c48bba/html5/thumbnails/4.jpg)
Why Create This?
• Eliminate barriers that prevent applications– Private, real-time determination– Online application available 24/7– Review/renewal at any time
![Page 5: OHCA Online Enrollment “Easy as 1-2-3 for SoonerCare members and partners” Richard Evans, Manager, Eligibility Automation and Data Integrity, OHCA](https://reader035.vdocuments.us/reader035/viewer/2022062423/56649f2f5503460f94c48bba/html5/thumbnails/5.jpg)
mySoonerCare.org Services
“From the privacy of your own home…” • Provide a place for individuals and families to enroll in
SoonerCare coverage– New first time applicants can start an application without
scheduling an appointment
– Get results and enroll real-time
– Select a Medical Home
• Provides member the ability to Manage your Account– Review your benefits
– Update information
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Understanding Multi-Program Interplay
“Multiple vehicles for submitting and processing applications…”
• Agency View – provides agency partners the ability to be an eligibility broker– Search for member or applicant– Verification of documentation: i.e. pregnancy and citizenship and identity – Update and change member information– Alerts for and Assist with the reenrollment process
• Notification of Date of Service form – provides hospitals the ability to reserve a date of application when a full application can not be competed that day.– Allows hospital claims to be paid when a full SoonerCare application is
received (within 15 days) and member is determined eligible
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Understanding Multi-Program Interplay
“Multiple vehicles for submitting and processing applications…”
• ODMHSAS provider application – provides facilities the ability to enroll applicants in state sponsored behavioral health services and assigns an ID that they will retain when they apply for SoonerCare
• Paper application – remain an option for applicants– Applications are scanned and data entered in system– Just as will all other application types the Rules Engine will
make the eligibility decision
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Putting the Pieces Together to Serve Members
State Department of Health• Providing eligibility resources • Piloting 16 counties with the agency view application• Data exchange for citizenship verifications
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Putting the Pieces Together to Serve Members
Department of Human Services • Providing eligibility resources • SoonerCare only clients assisted through agency view or
mySoonerCare.org • System interface for comprehensive applicants/members
to allow for rules engine determination and enrollment
![Page 10: OHCA Online Enrollment “Easy as 1-2-3 for SoonerCare members and partners” Richard Evans, Manager, Eligibility Automation and Data Integrity, OHCA](https://reader035.vdocuments.us/reader035/viewer/2022062423/56649f2f5503460f94c48bba/html5/thumbnails/10.jpg)
Putting the Pieces Together to Serve Members
Indian Health – Tribal • Leveraging current eligibility resources
• SoonerCare determination required before accessing
Contract Health Services funds.
Community Partners• Everyone's a partner – any organization with internet and
a willingness to assist Oklahomans.
![Page 11: OHCA Online Enrollment “Easy as 1-2-3 for SoonerCare members and partners” Richard Evans, Manager, Eligibility Automation and Data Integrity, OHCA](https://reader035.vdocuments.us/reader035/viewer/2022062423/56649f2f5503460f94c48bba/html5/thumbnails/11.jpg)
Considerations for Board
• Ground work laid for future programs: – Insure Oklahoma, – Breast and Cervical Cancer
• Health Reform initiatives – Expansion of FPL– Categorical relationship removal
• Coordinates well with Health Information Exchange
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Lessons Learned
• It takes a village
• Design tools – wireframe application utilized for focus groups and application flow
• A variety of approaches are critical
• Build partnerships and keep them alive
![Page 13: OHCA Online Enrollment “Easy as 1-2-3 for SoonerCare members and partners” Richard Evans, Manager, Eligibility Automation and Data Integrity, OHCA](https://reader035.vdocuments.us/reader035/viewer/2022062423/56649f2f5503460f94c48bba/html5/thumbnails/13.jpg)
For More Information . . .
• Contacts
Richard Evans, Manager
Eligibility Automation and Data Integrity
405.522.7101 - [email protected]
Derek Lieser , Project Manager
Planning and Development
405.522.7376 - [email protected]