Post on 18-Dec-2015
Deep Dive: FFM AssisterDeep Dive: FFM Assister
September 16, 2014APCA TrainingPriya HelwegCMS/Region 10Priya.helweg@cms.hhs.gov206-615-2598
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Session GoalsSession Goals
• Interactive!!• Recertification• Check information• Resources– Assister News Letter & List serve– Assister Trainings– Help with difficult situations
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FFM Assister Training, Certification, and Recertification Process for 2014-2015
FFM Assister Training, Certification, and Recertification Process for 2014-2015
• CMS Enrollment Assister Bulletin: 2014-01 Guidance Regarding Training, Certification, and Recertification for Navigator Grantees, Certified Application Counselors, and Non-Navigator Assistance Personnel in the Federally-facilitated Marketplaces: –http://www.cms.gov/CCIIO/Programs-and-Initiatives/Health-Insurance-Marketplaces/Downloads/FINAL-Recertification-Bulletin-08-15-2014.pdf
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How to Register How to Register
Instructions on how to register for certification/recertification
http://marketplace.cms.gov/technical-assistance-resources/training-materials/assister-training-instructions.pdf
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Becoming a CAC OrganizationBecoming a CAC Organization
• Application on http://marketplace.cms.gov• Certified Application Counselor– Certified through an organization– CAC designated organizations recertify existing
CACs within one year of the date the organization issued the CAC’s current certification.
– Organizations ensure successfully complete the 2015 CAC training before renewing their CAC certificates.
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RecertificationRecertification
• Use CAC ID number that has since been updated or changed by CAC organization
• Take the 2015 CAC training using his or her new CAC ID number, not the old ID number.
• The CAC ID number is the username entered on the MLN training registration page and will be reflected on the applicable training certificate that is generated upon successful completion of the training.
• Even if their individual CACs are not yet due for recertification, CAC designated organizations should encourage them to take the 2015 CAC training as soon as it becomes available.
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Certification Requirements for FFM Assisters
Certification Requirements for FFM Assisters
• FFM Assisters are required to complete CMS training courses and assessments to satisfy federal training requirements prior to being certified to provide consumer assistance in a FFM:
– All FFM certified application counselors (CACs) must complete the 6 online CAC Curriculum courses and their corresponding assessments with an 80% pass rate. All other courses are optional but recommended for CACs to review.
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Assisters must fulfill all training and certification requirements by the applicable deadline, and are strongly encouraged to complete these requirements prior to Open
Enrollment, which begins November 15, 2014.
Assisters must fulfill all training and certification requirements by the applicable deadline, and are strongly encouraged to complete these requirements prior to Open
Enrollment, which begins November 15, 2014.
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Check Your InformationCheck Your Information
• Get Local Help– Healthcare.gov– https://data.healthcare.gov/dataset/Local-Help/jmmh-
3bsr#column-menu
• Change information– To make updates or changes to your organization’s information,
go to Find Local Help and select the ‘Request Corrections’ link. For ease of reference the link has been copied here https://localhelp.healthcare.gov/update-organization-information/
– CACQuestions@cms.hhs.gov
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More ResourcesMore Resources
http://marketplace.cms.gov
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Assister’s ResourcesAssister’s Resources
• CMS weekly assister newsletter, please send a request via the CAC inbox (CACQuestions@cms.hhs.gov) and write “Add to listserv” in the subject line.
• Weekly webinar• Newsletter • Email CACQuestions@cms.hhs.govWe welcome suggestions and comments, so please
feel free to contact us.
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HelpHelp
• Call Center– Do this first
• CACQuestions@cms.hhs.gov – General questions
• CMS Regional Office – Priya Helweg– Urgent questions– Difficult cases– Trends
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Tips & TricksTips & Tricks
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Discussion/Learn from Each other/Questions&/or
Updates
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From Coverage to Care:Using the Roadmap & Discussion Guide
From Coverage to Care:Using the Roadmap & Discussion Guide
Cara V. James, PhD CMS Office of Minority Health
July 1, 2014
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• C2C is an effort to help educate consumers about their new coverage and to connect them with primary care and preventive services that are right for them so they can live long, healthy lives.
• Resources online and in print include the Roadmap, Discussion Guide, videos, and more.
• C2C builds on existing networks of community partners to educate and empower newly covered individuals.
What is From Coverage to Care?What is From Coverage to Care?
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• Start the Conversation. Use the Roadmap and Discussion Guide as a tool to help people understand their new coverage and understand the importance of getting the right preventive services.
• Help Consumers Understand. The Roadmap has a lot of information for consumers. You can help them use it as a resource to refer back to as they journey to better health and well-being.
• Personalize it. You know your community. Consider adding local resources and information.
How to Use the RoadmapHow to Use the Roadmap
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Coverage to Care RoadmapCoverage to Care Roadmap
16Online at marketplace.cms.gov/c2c
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Step 2: Understand Your Health Coverage
Step 2: Understand Your Health Coverage
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Key Points for Consumers
•Check with your insurance plan or state Medicaid or CHIP program to see what services are covered.•Be familiar with your costs (premiums, copayments, deductibles, coinsurance).•Know the difference between in-network and out-of-network.
Key Questions for Consumers •Do you know how to find a provider in your network?•Can you estimate how much you will pay when you see a provider?
1 STEP 2 3 4 5 6 7 8
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Key Terms On An Insurance CardKey Terms On An Insurance Card
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Key terms 1) Member Name2) Member Number3) Group Number4) Plan Type5) Copayment6) Phone Numbers7) Prescription
Copayment
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Sample Cost TablesSample Cost Tables
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Cost scenarios like managing Type 2
Diabetes and having a baby help consumers
understand what their care may cost, and how
their plan may divide these costs.
NOTE: These are not real costs.
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1 2 STEP 3 4 5 6 7 8
Step 3: Know Where To Go For CareStep 3: Know Where To Go For Care
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Key Points for Consumers•Only use the ER in a life-threatening situation.•Primary care is preferred when it isn’t an emergency. •Knowing the difference between primary care and care in the ER.
Key Questions for Consumers •Do you know how your costs would be different if you went to a primary care provider versus the Emergency Department? •Do you know how your care would be different?
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Newly covered consumers may not know when to visit a Primary Care Provider and when to use Emergency Department services.
Primary Care vs. Emergency CarePrimary Care vs. Emergency Care
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Visit http://marketplace.cms.gov/c2c
•Roadmap (English/Spanish)– Poster Roadmap– One-pagers: Insurance card, Primary care vs. emergency,
and EOB– Pull-out steps
•Discussion Guide (English)•Video vignettes (English/Spanish)
…and more to come!
Print copies available from the CMS Clearinghouse
Available C2C ResourcesAvailable C2C Resources
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Coveragetocare@cms.hhs.gov
Contact UsContact Us
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Marketplace Online Application Updates
Marketplace Online Application Updates
• Streamlined version– Improved flow– More dynamic– Fewer screens to navigate– Optimized for mobile users– Backward navigation – Updated look and feel
• Shorter, smoother, simpler user experience24
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Consumer ExperienceConsumer Experience
• Improved application process is seamless and transparent to users– User is guided through the appropriate version
based on answers to screening questions– Seamless to user – won’t know there are different
pathways.
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Phased in GraduallyPhased in Gradually
• On a rolling basis• Randomly released to increasing subset of
HealthCare.gov users • From Sept – Open enrollment• You may not see a change right away or for
every consumer.
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Account CreationAccount Creation
• In the improved online application, account creation is completed on one, long screen, instead of using a separate screen for each section. This requires fewer clicks and makes the account creation process simpler and faster.
• Remember, those using the shorter, streamlined application process will only be new consumers who haven’t previously applied for Marketplace coverage. As such, the only option they’d choose on this page would be “Apply for new coverage.”
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Various ChangesVarious Changes
• After creating an account• The identity proofing process now starts with
“Enter Your Information” page instead of the “Contact Information”
• Same information, but in a more streamlined format
• The new “Verify Your Identity” page displays the same types of questions as before, but with a different look and better flow from the “Enter Your Information” screen.
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• “Before You Get Started” page, more personal information required• A number of screens have been consolidated here to streamline the
process and make it shorter than in the traditional application.• At this point in the traditional application, you would need to enter
your contact information and details about your family members applying for coverage.
• In the updated application process, you will move on to answer a new set of screening questions to see if you have any of the more complex situations that would require you to fill out the traditional application. If not, you can continue on with the shorter application with a new look and feel.
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New SectionNew Section
• The “Answer Some Questions” page is a brand new section of the updated application. There are up to 16 questions on this page. Depending on your answers to some of the screening questions, other questions may or may not appear. How you respond to these screening questions determines whether you complete the shorter, streamlined application or go through the more detailed, traditional application. We expect about 70% of applicants to use the shorter application; the remaining 30%, who have more complicated household scenarios, will use the traditional Marketplace application.
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Key Points to RememberKey Points to Remember
• Updated, shorter Marketplace application for consumers with simple household situations
• Streamline application will be phased in to OE• You may now see changes right away or often• Consumers will be automatically routed through
the correct application process for their situation• Updates will be fully implemented by OE but
every consumer won’t have this updated application.
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Questions?Questions?
Priya HelwegCMS/Region 10
Priya.helweg@cms.hhs.gov206-615-2598
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