Borrego Health Serving Your Medical and Dental Needs

  • Slides: 40
Download presentation
Borrego Health Serving Your Medical and Dental Needs Your Medical and Dental Home

Borrego Health Serving Your Medical and Dental Needs Your Medical and Dental Home

Company Mission Statement To be the community leader in improving the health of the

Company Mission Statement To be the community leader in improving the health of the populations in our service area. Our primary focus is the underserved, with an empowered workforce providing measurable quality and compassionate care. Company Vision Statement “To provide the best healthcare, by creating a culture of excellence that focuses on people, service, quality, financial sustainability and growth”.

Company Core Values • Accountability – we stand behind our actions • Compassion –

Company Core Values • Accountability – we stand behind our actions • Compassion – we treat patients like loved ones • Integrity- we believe the time is always right to do the right thing • Respect – we value each person’s thoughts and needs • Commitment – we are dedicated in meeting our customer’s needs and expectations • Loyalty – we stand by Borrego Health • Excellence – we deliver the highest quality service

About Borrego Health • Borrego Health is a, non-profit Federally Qualified Health Center operating

About Borrego Health • Borrego Health is a, non-profit Federally Qualified Health Center operating in San Diego and Riverside counties – there are currently 13 clinics in Riverside, Eastern Coachella Valley and San Diego • Borrego Health tailors primary care and preventive health services (medical and dental) to meet the health needs of men, women, children, adolescents and senior citizens in our surrounding communities, and those at risk of developing chronic diseases such as diabetes.

Borrego Health provides high quality, efficient customer focused health care to the communities we

Borrego Health provides high quality, efficient customer focused health care to the communities we serve, accomplished by providing access to patient centered comprehensive care to all residents regardless of their ability to pay.

Programs Offered at Borrego Clinics Program Description CHDP Well Child Exams FPACT/ EWC Woman’s

Programs Offered at Borrego Clinics Program Description CHDP Well Child Exams FPACT/ EWC Woman’s Health BCCTP Breast, Cervical Cancer Treatment Program SFS Slide Fee Scale PE Temporary Medi-Cal; eligibility for prenatal care Medi-Cal, Application assistance Covered Ca, information on other programs available.

CHDP Program Overview • The CHDP program provides complete health assessments for the early

CHDP Program Overview • The CHDP program provides complete health assessments for the early detection and prevention of disease and disabilities for lowincome children and youth. • A health assessment consists of a health history, physical examination, developmental assessment, nutritional assessment, dental assessment, vision and hearing tests, a tuberculin test, laboratory tests, immunizations, health education/anticipatory guidance, and referral for any needed diagnosis and treatment • The CHDP program oversees the screening and follow-up components of the federally mandated Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program for Medi. Cal eligible children and youth.

What Does CHDP Offer? • CHDP provides a schedule of periodic health services to

What Does CHDP Offer? • CHDP provides a schedule of periodic health services to non-Medi-Cal children and youth from birth to age 19 years whose family income is equal to or less than 200 percent of the federal income guidelines. • All children and youth are eligible for health assessments based on the same schedule or periodicity used for Medi-Cal children and youth

School Children 4 Through 12 Years School Check-Ups • • • Babies and Toddlers

School Children 4 Through 12 Years School Check-Ups • • • Babies and Toddlers Birth Through 3 Years Regular Well-Baby Care and Shots • • State law requires Babies and toddlers need health check-ups children entering kindergarten or first often. grade to have a health • • They need to get their shots on time. How often? • • One exam during each of these age ranges: Health check-ups may find health problems that could Under 1 month 10 -12 months prevent a child from doing well in school. How often? • • 1 -2 months 13 -15 months 3 -4 months 16 -23 months 5 -6 months 2 years 7 -9 months check-up and be up-todate on their shots. teenagers and Young Adults 13 Through 20 Years Health Check-Ups Teens need check-ups too! They may have questions about their health. They can ask a health care provider. How often? One exam during each of these age ranges: Between 13 -16 years Between 17 -20 years Ask your doctor or local health One exam during each of department these age ranges: for other services for teenager Between 4 -5 years Between 6 -8 years Between 9 -12 year

New Born Referral (NBR) • If baby’s mother was receiving Medi-Cal benefits at the

New Born Referral (NBR) • If baby’s mother was receiving Medi-Cal benefits at the time of baby’s birth, the baby may be eligible for Medi-Cal • What is the Newborn Referral Form? • The Newborn Referral Form is a California State Department of Health Care Services form (Form number MC 330) used to notify a local county Medi-Cal office that a baby has been born to a mother on Medi-Cal. Sending the form will help insure that the infant has Medi-Cal at least until his/her first birthday, when Medi-Cal must be renewed. • • Many doctor’s offices and clinics that are part of the Child Health and Disability Prevention (CHDP) program can also start Medi-Cal when a baby or child comes for a visit.

Women's Health Programs Family Pact Family PACT is a program that provides no-cost family

Women's Health Programs Family Pact Family PACT is a program that provides no-cost family planning services to low-income men and women, including teens. Many doctors and clinics all over California are part of the Family PACT program. Family PACT is ready to serve the diverse populations living in California.

Family PACT can help you: • Prevent an unplanned pregnancy. • Protect your reproductive

Family PACT can help you: • Prevent an unplanned pregnancy. • Protect your reproductive health by helping you take care of yourself so that you can have a healthy baby when you are ready. • Find out about birth control methods. • Get the education, counseling, and treatment you need

Who is eligible? • Women, and teens able to become pregnant or cause a

Who is eligible? • Women, and teens able to become pregnant or cause a pregnancy can get Family PACT services if they are low-income California residents. You may qualify for Family PACT Note: You do not need to ask for proof of what the patient reports to you.

EWC: Every Women Counts • The Cancer Detection Programs: Every Woman Counts (CDP: EWC)

EWC: Every Women Counts • The Cancer Detection Programs: Every Woman Counts (CDP: EWC) provides free clinical breast exams, mammograms, pelvic exams and Pap tests to California’s underserved women.

Do you qualify for free services? You may if you: • Are 40 years

Do you qualify for free services? You may if you: • Are 40 years old or older (Breast exam and Pap) • Are 21 years old or older (Pap only) • Have low income • Have medical insurance that does not cover breast cancer screening • Have a high insurance deductible or co-payment • Are not getting these services through Medi-Cal or another government-sponsored program • Live in California

PE: Presumptive Eligibility for Pregnant Women is a Medi-Cal program designed to provide immediate,

PE: Presumptive Eligibility for Pregnant Women is a Medi-Cal program designed to provide immediate, temporary coverage for prenatal care to low income pregnant women

Who is eligible? • Any women who thinks she is pregnant and whose family

Who is eligible? • Any women who thinks she is pregnant and whose family income is under a certain amount is eligible for Presumptive Eligibility (PE) for Pregnant Women.

What kind of prenatal care can I receive when enrolled in the PE program?

What kind of prenatal care can I receive when enrolled in the PE program? • PE offers specific ambulatory (walk-in) prenatal care, limited family planning services, and prescription drugs for conditions related to pregnancy. What care is NOT covered by the PE PROGRAM? • PE is a temporary Medi-Cal program that does not offer emergency care, labor and delivery, or inpatient care. That is why it is important for PE patients to apply for Medi-Cal on a timely basis.

B. C. C. T. P. The Breast and Cervical Cancer Treatment Program (BCCTP) provides

B. C. C. T. P. The Breast and Cervical Cancer Treatment Program (BCCTP) provides needed cancer treatment to eligible individuals diagnosed with breast and/or cervical cancer and who are in need of treatment.

You may receive full-scope Medi-Cal through BCCTP if you meet all of the following:

You may receive full-scope Medi-Cal through BCCTP if you meet all of the following: • Have been screened and found to be in need of treatment for breast and/or cervical cancer , follow-up care for cancer or precancerous cervical lesions/conditions by an CDP: EWC or Family PACT provider • Are a California resident • Have a monthly gross family income at the time of screening and diagnosis, that is at or below 200 percent of the federal poverty level for the family size • Have no other health insurance including full-scope no share-of-cost Medi-Cal or Medicare.

Who is eligible? • Are a California resident? • Are a male of any

Who is eligible? • Are a California resident? • Are a male of any age or any immigration status? • Are a female of any age with non-citizen or unsatisfactory immigration status? • And/or have health insurance, including share-of-cost Medi-Cal and/or Medicare? NOTE: If you do not have satisfactory immigration status you may be eligible for restricted Medi-Cal and the Statefunded BCCTP. Restricted Medi-Cal will provide benefits for emergency services, pregnancy services and long-term care.

5 THINGS YOU NEED TO KNOW About Health Coverage For ALL California Children 1)

5 THINGS YOU NEED TO KNOW About Health Coverage For ALL California Children 1) Governor Brown and legislative leaders signed a budget that allocates new funding to cover all low-income children, up to 19 years old, regardless of immigration status, through Medi-Cal. 2) Implementation may begin as early as May 1, 2016. BUT families can prepare now! 3) Families should enroll their children NOW in restricted scope Mei-Cal, also known as “emergency” Medi-Cal should renew their coverage, in order to smoothly transition to full-scope Medi-Cal after May 1. 4) Children do not need to have Medi-Cal emergency to enroll in “emergency” Medi-Cal. 5) Full scope Medi-Cal means access to preventive services and peace of mind for California’s families.

MEDI-CAL/COVERED CA • Borrego Health can provide Medi-Cal and Covered California (Obama Care) application

MEDI-CAL/COVERED CA • Borrego Health can provide Medi-Cal and Covered California (Obama Care) application assistance at all Borrego Sites. • Care Coordinator Specialists (CCS) are available in both clinic locations and are ready to help you apply for low to no-cost programs you may qualify for.

MEDI-CAL • EXPANSION OF THE MEDI-CAL PROGRAM: • Persons with incomes up to 138%

MEDI-CAL • EXPANSION OF THE MEDI-CAL PROGRAM: • Persons with incomes up to 138% of FPL are eligible • Adults w/out children aged: 19 -64 are now eligible • Eligibility is now based on income • No special enrollment period; can enroll anytime • Foster care children now covered to age 26 • Some dental benefits have been restored for adults

COVERED CALIFORNIA

COVERED CALIFORNIA

Covered California

Covered California

Sliding Fee Scale It is the policy of Borrego Community Health Foundation (BCHF) and

Sliding Fee Scale It is the policy of Borrego Community Health Foundation (BCHF) and the affiliate clinics to provide essential services regardless of the patient’s ability to pay for those residing within the clinic’s designated service area. Discounts are offered to all individuals and families that meet the requirements of family income and size. A sliding fee schedule is used to calculate the basic discount that is updated each year using the current federal poverty guidelines for families with income at or below 200% of poverty. Families at or below 100% of poverty will pay a minimum fee only. All applicants will be assessed for eligibility of other public healthcare coverage and assisted with the application process. ELIGIBILITY DETERMINATION • • • Proof of Identity Proof of Service Area Residency Proof of Income

Covered Services: – – – Flu shots Face to face encounters require copay Lab

Covered Services: – – – Flu shots Face to face encounters require copay Lab fees over $10 need to be authorized by manager Immunizations covered, based on medical necessity Physicals – – – Copays: SFS-A: $30 SFS-B: $40 SFS-C: $55 SFS-D: $70 SFS-E: $85

Self Pay • Patient is responsible for all balances. • A $75 Non-Refundable Deposit

Self Pay • Patient is responsible for all balances. • A $75 Non-Refundable Deposit is required to be seen. (Unless nurse/doctor determine otherwise) • For LAB work, patient will be billed according to the lab price. Lab Technician must use UPPE code on Lab requisition. • All Immunizations must be paid before being administered. *Payment plan is acceptable as last resort. • Please advise patient of any procedures that might be required during the visit before being performed, since they will be responsible for payment. Back office may check with billing for pricing.

 Who can help you apply and enroll in these programs?

Who can help you apply and enroll in these programs?

Care Coordinator Specialist Who we are and what do we promote to the community

Care Coordinator Specialist Who we are and what do we promote to the community we serve Caring and Compassion: We treat those we serve and one another with concern, kindness and respect. Honesty and Integrity: We act openly and truthfully in everything we do. Teamwork: We work together cooperatively, recognizing that the power of our combined efforts exceeds what we can accomplish individually. Community: We acknowledge our vital role in local communities, and we seek to Understand serve their needs. Excellence and Quality: We are committed to quality and to adding value in every aspect of our work, and we strive to exceed the expectations of our consumers. Education, Teaching and Training: We strive to create an educational environment for our consumers, our employees, our communities, and for the training of professionals dedicated to serve the underserved.

Borrego Clinics • Arlanza Family Health Center • 8856 Arlington Avenue Riverside, CA 92503

Borrego Clinics • Arlanza Family Health Center • 8856 Arlington Avenue Riverside, CA 92503 Phone: (951) 710 -3970 Clinic Hours Monday – Wednesday-Friday: 8: 00 am 7: 00 pm Tues-Thursday 8: 00 am -5: 00 pm Saturday 8: 00 am -12: 00 pm Sunday and Holidays: Closed During closed hours, a provider is available through our answering service Dental Hours Monday - Friday: 8: 00 am-12: 00 pm; 1: 00 pm-5: 00 pm Saturday -Sunday and Holidays: Closed During closed hours, a provider is available through our answering service

 • Eastside Health Center • 1970 University Avenue Riverside, CA 92507 Phone: (951)

• Eastside Health Center • 1970 University Avenue Riverside, CA 92507 Phone: (951) 213 -3450 Clinic Hours of Operation Monday-Friday: 8: 00 am-7: 00 pm Saturday 8 -12 pm, Sunday and Holidays: Closed During closed hours, a provider is available through our answering service Dental: Hours Monday-Friday: 8: 00 am-12: 00 pm; 1: 00 pm -5: 00 pm

 • Centro Medico Cathedral City • 69175 Ramon Road, Suite A Cathedral City,

• Centro Medico Cathedral City • 69175 Ramon Road, Suite A Cathedral City, CA 92234 Phone: (760) 321 -6776 • DESERT HOT SPRINGS COMMUNITY HEALTH CENTER - MAIN CAMPUS • 66675 Pierson Blvd. Desert Hot Springs, CA 9224 -4559 • Phone: (760) 676 -5240 Monday-Friday: 8: 00 am-5: 00 pm Urgent Care Hours Monday-Friday: 8: 00 am-8: 00 pm Saturday: 8: 00 am - 5: 00 pm Sunday and Holidays: 8: 00 am - 12: 00 pm During closed hours, a provider is available through our answering service Monday-Friday: 8: 00 am-5: 00 pm Saturday, Sunday: 8: 00 am-12: 00 pm Urgent Care Hours Monday-Friday: 8: 00 am-8: 00 pm Saturday and Sunday: 8: 00 am-12: 00 pm

 • Desert Hot Springs Wellness Center • 11750 Cholla Drive, Suite B Desert

• Desert Hot Springs Wellness Center • 11750 Cholla Drive, Suite B Desert Hot Springs, CA 92240 Phone: (760)251 -0044 Dental: (760) 676 -5900 • Health Center - Brought to you by Borrego Health featuring 4 Dental Exam Stations and 2 Medical Exam rooms for physicals and teen confidential services

 • Desert Oasis Women’s Health Center 11180 North Indian Canyon Drive Suite W-300

• Desert Oasis Women’s Health Center 11180 North Indian Canyon Drive Suite W-300 Palm Springs, CA 92262 Phone: (760) 416 -3770 Monday- Friday: 8: 00 am-5: 00 pm Saturday, Sunday and Holidays: Closed • Borrego Health Specialty Care Clinic 69175 Ramon Road, Suite A Cathedral City, CA 92234 Phone: (760) 321 -6776 Monday-Friday: 9: 00 am-4: 00 pm (Closed 12: 00 pm-1: 00 pm for Lunch) Saturday, Sunday and Holidays: Closed

 • Centro Medico Coachella 55557 Campus Road PO BOX 69 Thermal, CA 92274

• Centro Medico Coachella 55557 Campus Road PO BOX 69 Thermal, CA 92274 Phone: (760)399 -4526 Clinic Hours Monday - Friday: 7: 00 am-5: 00 pm Saturday, Sunday and Holidays: Closed During closed hours, a provider is available through our answering service Dental Hours Monday - Friday: 8: 00 am-12: 00 pm; 1: 00 pm-5: 00 pm Saturday, Sunday and Holidays: Closed

 • Centro Medico Oasis 88775 Avenue 76, Suite #1 Thermal, CA 92274 Phone:

• Centro Medico Oasis 88775 Avenue 76, Suite #1 Thermal, CA 92274 Phone: (760)397 -2501 Clinic Hours Monday-Friday: 8: 00 am-6: 00 pm Urgent Care Hours Saturdays and Sundays: 8: 00 am-1: 00 pm Holidays: 8: 00 am-12: 00 pm • Borrego Medical Clinic 4343 Yaqui Pass Road Borrego Springs, CA 92004 -2369 Phone: (760) 767 -5051 Clinic Hours Monday- Friday: 8: 00 am-5: 00 pm Saturday Sunday and Holidays: Closed

Questions and Answers

Questions and Answers