CAREWare Eligibility Documents Training CAREWare Eligibility AREAS COVERED
CAREWare Eligibility Documents Training
CAREWare Eligibility
AREAS COVERED • • Background Eligibility Documents Technical Specs Procedures for shared documentation
WHY CHANGE THE PROCESS?
Added value to our clients Ryan White as an EMA provides health care services to people affected by HIV/AIDS. Our community is often times the hardest hit, with the fewest resources. Getting into care can be difficult for people living with so few means. As such it is our responsibility as an EMA to remove barriers to entry for our client base. The Ryan White patient population will often times need to visit multiple clinics to for all of their health needs. Currently this means that with each new clinic or health care provider a patient will have to produce the same documentation multiple times. The goal of this project is to reduce unnecessary obstacle by sharing client level documentation which adds real value to our population.
WHAT ARE ELIGIBILITY DOCUMENTS The documents are what clients must provide clinics to prove that they are Ryan White eligible.
Types of eligibility • Proof of income • Provides documentation that shows that the client is below the earnings threshold • Proof of residency • The client must reside in the 20 county area covered by our EMA • Proof of HIV status • The client must have HIV or be HIV affected
Other Requirements • Uninsured or underinsured • Not eligible for third party programs • Proof this is not covered by third party insurance such as Medicaid or Medicare Ryan White is a payer of last resort. If another source is available that source must be utilized first.
Proof of Income Acceptable Documents Include: • Check stubs listing gross wages/employer’s statement listing gross wages • Supplemental Security Income (SSI) checks or benefit/award letters • Social Security Administration (SSA) checks or benefit/award letters • Temporary Assistance to Needy Families (TANF) checks or benefit/award letters • Section 8 Rental Assistance Statement • Other letters of Notification of Benefits (e. g. , Medicaid, Medicare, SNAP, private disability, retirement/pension, Worker’s Compensation, Veteran’s Administration, WIC Program, Low Income Subsidy, etc. ) • Other public assistance checks • Current W-2 Wage and Tax Statement forms • Third party screenings (TPQY) for verifying SSA/SSI benefit information • Notarized letter from Head of Household (HOH) detailing the client’s relationship to the HOH and the level of financial assistance provided to the client • Income from rental property • Child support/court order check • A zero income letter (on letterhead) from a shelter or residential treatment facility located in the Atlanta EMA • In extreme and rare cases, a notarized self-declaration letter from the client indicating their income (must be signed off on by the client’s Medical Case Manager)
Proof of Residency It is not necessary to be a U. S. citizen to receive Ryan White Part A services. Applicants do not have to document citizenship or immigration status in order to be eligible for services. Service providers are not required to report undocumented clients to the Immigration and Naturalization Service (INS). Any one of these documents will be accepted as proof of residency as long as the address is a land address, not a P. O. Box, issued within the past twelve months, not expired, and is the same as the client’s stated address on intake/application documents. Such official documents with address present include:
Proof of Residency Documents • • • • Current Lease/Rental Agreement Mortgage indicating the client’s name and residence Food stamp documentation General assistance documentation TANF (Temporary Assistance for Needy Families) documentation Social Security or Veteran’s Administration Benefits award letter Unemployment award/benefits statement Property tax statement Homeowners Association (HOA) assessment/fee statement, or Current Lease/Rental Agreement Non-property tax bill or tax assessment statement W-2 (tax) form from employer (most recent tax year) Check stub from employer (most recent tax year) • • • • Bank statement (most recent month) Driver’s license issued by the State of Georgia issued identification card Utility bills US Passport Unemployment document with address Current voter registration card School identification US Visa (immigrant and non-immigrant) Notarized statement from a homeless service provider (shelter, clinic, food program, etc. ) verifying homelessness A billing statement from a department store, doctor’s office, or insurance company, cell phone company An official piece of mail such as a jury summons A statement from a service provider indicating the provider has met with client in a home visit at a specific address in the Atlanta EMA.
Proof of HIV Status Medical documentation of HIV status is required. Any of the following documents would be acceptable: • A positive HIV antibody test result (Reactive IA/ELISA screening test) confirmed by Western Blot, Immunofluorescense Assay (IFA), Nucleic Acid Testing (Aptima), Multispot® HIV-1/HIV-2 Rapid Test by blood or oral fluid. • A positive HIV direct viral test such as PCR or P 24 antigen. • A detectable HIV viral load (undetectable viral load tests are NOT proof of HIV) • A viral resistance test result • 4 th Generation testing • A statement or letter signed by a medical professional (acceptable signatories are listed below), on office letterhead/prescription pad indicating that the individual is HIV positive and must accompany a lab test to confirm current HIV status within 60 days • Presumptive diagnosis based upon lab results, and/or medical therapies prescribed by a previous medical provider.
Link for patients to check their eligibility https: //www. gacapus. com/r/eligibility/
Any questions?
Technical Requirements
Technical tools to be in compliance • • • Computer Internet Connection VPN Scanner CAREWare
COMPUTER The computer is where the documents will be stored locally and how you will access CAREWare
INTERNET CONNECTION To access the web
VPN The VPN will provide you access to the central CAREWare Database
SCANNER A scanner is needed to scan the eligibility documents onto your computer
CAREWARE CAREWare will be the central repository for all of the documentation
In addition: Please make certain that you inform the Part A office if you do not have access to the eligibility section or cannot upload the documents. This is where your help is appreciated.
Any questions?
Shared Documentation Procedures for uploading eligibility documentation
OBTAIN THE CLIENT DOCUMENTS Whatever documents that they may have you would obtain them the same way that you already do
Scan the documents into your PC • Scan document into your computer • Save files to: C: UsersDocumentsEligibility_docs • Name Proof of Income document POI_URN_[date as mmddyyyy] • Name Proof of Residency document ROI_URN_[date as mmddyyyy] • Name HIV/AIDS Verification document HDV_URN_[date as mmddyyyy] • Name Insurance document In. D_URN_[date as mmddyyyy]
Scan document into your computer • Save files to: C: UsersDocumentsEligibility_docs
Use a universal naming convention to keep the client files clean across the EMA • Name Proof of Income document POI_URN_[date as mmddyyyy] • Name Proof of Residency document ROI_URN_[date as mmddyyyy] • Name HIV/AIDS Verification document HDV_URN_[date as mmddyyyy] • Name Insurance document In. D_URN_[date as mmddyyyy]
For example:
DIFFERENT AGENCIES WILL USE THIS DOCUMENT Since these documents can be used by different agencies the naming must be consistent. Plus it provides for easy patient searches. DOCUMENTS MUST BE PDF!
ONCE SAVED IN LOGON TO CAREWARE.
Find the client associated with the documentation
Click on the tab that states: Eligibility Documents
Select the link for the document that you would like to upload.
Click Attach New File(s)
Select the file to add
You must select Content Type. Then click ‘Save’
Upload Files
File is uploaded
Once uploaded you can: F 1 -Attach New File(s) F 2 -Edit Content Description F 3 -Delete Attachment(s) F 4 -View Attachment(s)
Selecting View Attachment will show you the document
Any questions?
Clients should be asked and checked • Ask if they are already a Ryan White Client • If “NO” then you will need to collect documentation and complete the documentation process • If “YES” check the client in CAREWare for the documents. If they are available download a copy for your agency. • You will only need to do this process for entry and recertification. It is not necessary for each visit.
Thank you all for your continued support of Ryan White Part A. With your support we make our clients care and experience first rate.
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