WPA Provider Update Spring 2008
June 17, 2008

 

WPA Provider Update: Spring 2008

 

Thank you for continuing to support Whatcom Project Access (WPA) the partnership between the Whatcom County Medical Society and the Whatcom Alliance for Healthcare Access (WAHA), that coordinates donated specialty care and supporting services for eligible, low-income, uninsured patients in our community.

 

In this issue of the WPA Update, we would like to:

·         Inform you about additional services that WAHA can provide for you, your patients, and the wider community

·         Invite you to visit WAHA’s new, improved website that includes an expanded section on Whatcom Project Access with information for both providers and patients 

 

Whatcom Alliance for Healthcare Access:

The goal of the Whatcom Alliance for Healthcare Access is to ensure access to healthcare services for all members of our community. WAHA is focused on the following local solutions:

• Providing information and assistance about health insurance and accessing health care in Whatcom County
• Recruiting physicians to the area and retaining the doctors already serving Whatcom County
• Providing information for decision makers and the community about sound healthcare policies

 

 

Insurance Counseling:

WAHA’s Access Counselors help individuals, families, business owners, and patient advocates navigate the healthcare system with the following free services:

• Easy-to-understand, impartial information on how to get, use, and keep health insurance
• Free insurance counseling and assistance completing paperwork
• Assistance with enrollment in Medicaid, Children’s Health Insurance Plan (CHIP), Basic Health and other insurance programs

For more information or to schedule an appointment – call WAHA at (360) 788-6594.

 

SHIBA HelpLine:

SHIBA HelpLine is a statewide network of trained volunteers who educate, assist and advocate for consumers about their rights and options regarding health insurance and health care access. A free counseling service of the Washington Office of the Insurance Commissioner, the Whatcom SHIBA HelpLine is sponsored by WAHA.

 

SHIBA HelpLine is:

• Completely FREE
• Confidential—your personal information is kept safe and private
• Accessible—some operators and volunteers are bi-lingual
• Impartial/objective/unbiased—we don’t sell or endorse anything

           

Whatcom SHIBA HelpLine: (360) 788-6533 or (800) 562-6900

 

Health Policy Education:

WAHA is committed to progress on health policy issues that improve healthcare access for all residents of Whatcom County. Recognizing the interrelatedness of local solutions and state and federal health policies, WAHA seeks to provide nonpartisan analysis for decision makers and educate the community about:

• Current state and federal healthcare policies that impact the Whatcom County healthcare delivery system and our ability to ensure access to all members of our community
• Broader issues of national and state healthcare policy trends relevant to local access

 

WAHA’s legislative priorities for 2008 included:

Medicare Reimbursements

Safety Net Care Involvement

SCHIP Renewal

School Outreach

Small Business Insurance

Loan Repayment Program

 

More information is available at: http://www.whatcomalliance.org/policy/index.htm

 

Physician Recruitment and Retention:

Representatives of WAHA, medical providers, and the business sector participate in a community oversight committee to guide the Whatcom County physician recruitment and retention effort.  Because a patient´s ability to access health care is closely related to the number of physicians in a community, our aim is to increase the number of medical practices accepting new Medicaid and Medicare patients and participating in community safety net programs. Activities include:

 

• Assessment and Planning: ongoing community needs assessments and long-term planning for physician recruitment 
• Recruitment: collaborative recruitment strategy aimed at ensuring access to care in Whatcom County
• Retention: ongoing support and business counseling services to existing practices, recruited physicians, and their families to improve retention and continuity of care

 

 

More information is available at: http://www.whatcomalliance.org/physician/index.htm

 

Whatcom Project Access (WPA) Information

 

Current Specialty Services Available Through WPA:

 

Allergy Immunology Anesthesiology* Cardiac Surgery Cardiology Chiropractic Dermatology Endocrinology Gastroenterology General Surgery Imaging*

Infectious Disease Internal Medicine Laboratory* Neurology Neurosurgery Oncology Ophthalmology Orthopedics Orthotics* Otolaryngology

Pathology* Physical Therapy* Plastic Surgery Pulmonology Radiology* Rheumatology Sleep Disorder Center Sports Medicine Surgery Center* Vascular Surgery

*Please note: WPA does not accept referrals for ancillary services, such as imaging.  Donated ancillary services are used to compliment and support donated specialty care.

 

Eligibility Guidelines:

· Patient must reside in Whatcom County.

· Patient is not eligible for Medicare, Medicaid, or other health insurance (including High Deductible Health Plans).

· Verifiable gross family income does not exceed 200% of the federal poverty level.

· Patient is required to provide proof of income, assets, and Whatcom residency.

· WPA uses the same eligibility requirements used by St. Joseph Hospital’s Bridge Assistance Program and Basic Health.

 

Program procedures:

1.     WPA receives referrals from Community Health Centers, private primary care physicians, specialty physicians, and the St. Joseph Emergency Department.

2.     WAHA Access Counselors make several attempts over a two-week period to contact the patient. A brief screening is completed over the phone to determine if a patient may be eligible for WPA; if so an intake is scheduled for the patient.

3.     If we are unable to contact patient, they do not qualify, or the patient does not complete the intake process, the referral is returned to the referring provider. 

4.     If a patient qualifies, they are scheduled for an intake appointment. 

·          First, patients meet with the WAHA Access Counselor, who provides information and assistance applying for insurance, including Basic Health, and St. Joseph Hospital Bridge Assistance program. 

·          Next, the patient meets with the Care Coordinator who discusses how the program works and arranges the first appointment with the next available volunteer specialist.

5.     When a patient is enrolled and scheduled, we will contact your office with appointment information. At this time, we will request that you fax appropriate chart notes directly to the specialist office prior to the first appointment.

6.     Patients are generally enrolled for a three-month period.  However, if they continue to pay their Basic Health premium and need additional specialty care, WPA may extend a patient’s enrollment to cover the 9 month “waiting period” for pre-existing conditions.

 

For more information, visit www.whatcomalliance.org or call WPA at 788-6594. 

 

To refer a patient you believe may be eligible, fax a referral form to 788-6587. 

 

Please forward this newsletter to anyone who might be interested!