2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs...
Transcript of 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs...
![Page 1: 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1 2017 Chronic Condition and Dual Special Needs Plans 1.](https://reader033.fdocuments.in/reader033/viewer/2022041615/5e3a83b637687e7712222958/html5/thumbnails/1.jpg)
2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1
2017 Chronic Condition and Dual Special Needs Plans 1. Welcome
1.2 Welcome/Learning Objectives
![Page 2: 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1 2017 Chronic Condition and Dual Special Needs Plans 1.](https://reader033.fdocuments.in/reader033/viewer/2022041615/5e3a83b637687e7712222958/html5/thumbnails/2.jpg)
2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 2
1.3 Certification Requirements
2. SNP Common Features 2.1 SNP Overview
![Page 3: 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1 2017 Chronic Condition and Dual Special Needs Plans 1.](https://reader033.fdocuments.in/reader033/viewer/2022041615/5e3a83b637687e7712222958/html5/thumbnails/3.jpg)
2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 3
Who? (Slide Layer)
What? (Slide Layer)
![Page 4: 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1 2017 Chronic Condition and Dual Special Needs Plans 1.](https://reader033.fdocuments.in/reader033/viewer/2022041615/5e3a83b637687e7712222958/html5/thumbnails/4.jpg)
2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 4
When? (Slide Layer)
2.2 SNP Key Features
![Page 5: 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1 2017 Chronic Condition and Dual Special Needs Plans 1.](https://reader033.fdocuments.in/reader033/viewer/2022041615/5e3a83b637687e7712222958/html5/thumbnails/5.jpg)
2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 5
Networks (Slide Layer)
Drug Coverage (Slide Layer)
![Page 6: 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1 2017 Chronic Condition and Dual Special Needs Plans 1.](https://reader033.fdocuments.in/reader033/viewer/2022041615/5e3a83b637687e7712222958/html5/thumbnails/6.jpg)
2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 6
Who Pays What? (Slide Layer)
2.3 Care Management
![Page 7: 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1 2017 Chronic Condition and Dual Special Needs Plans 1.](https://reader033.fdocuments.in/reader033/viewer/2022041615/5e3a83b637687e7712222958/html5/thumbnails/7.jpg)
2.4 Health Risk Assessment
2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 7
Low-Moderate Risk (Slide Layer)
![Page 8: 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1 2017 Chronic Condition and Dual Special Needs Plans 1.](https://reader033.fdocuments.in/reader033/viewer/2022041615/5e3a83b637687e7712222958/html5/thumbnails/8.jpg)
High Risk (Slide Layer)
2017 Chronic Condition and Dual Special Needs Plans 06032016 P a g e | 8
2.5 HouseCalls
![Page 9: 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1 2017 Chronic Condition and Dual Special Needs Plans 1.](https://reader033.fdocuments.in/reader033/viewer/2022041615/5e3a83b637687e7712222958/html5/thumbnails/9.jpg)
2017 Chronic Condition and Dual Special Needs Plans 06032016 P a g e | 9
2.6 Checkpoint (Matching Drop-down, 0 points, unlimited attempts permitted)
Feedback when correct:
That's right! You selected the correct responses.
![Page 10: 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1 2017 Chronic Condition and Dual Special Needs Plans 1.](https://reader033.fdocuments.in/reader033/viewer/2022041615/5e3a83b637687e7712222958/html5/thumbnails/10.jpg)
2017 Chronic Condition and Dual Special Needs Plans 06032016 P a g e | 10
3. DSNP Overview 3.1 Medicaid Overview
Medicaid 101 (Slide Layer)
![Page 11: 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1 2017 Chronic Condition and Dual Special Needs Plans 1.](https://reader033.fdocuments.in/reader033/viewer/2022041615/5e3a83b637687e7712222958/html5/thumbnails/11.jpg)
Why Is It Important To Understand Medicaid (Slide Layer)
2017 Chronic Condition and Dual Special Needs Plans 06032016 P a g e | 11
3.2 Medicare Savings Program
![Page 12: 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1 2017 Chronic Condition and Dual Special Needs Plans 1.](https://reader033.fdocuments.in/reader033/viewer/2022041615/5e3a83b637687e7712222958/html5/thumbnails/12.jpg)
2017 Chronic Condition and Dual Special Needs Plans 06032016 P a g e | 12
3.3 Full Dual-Eligible
3.4 Partial Dual-Eligible
Notes:
![Page 13: 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1 2017 Chronic Condition and Dual Special Needs Plans 1.](https://reader033.fdocuments.in/reader033/viewer/2022041615/5e3a83b637687e7712222958/html5/thumbnails/13.jpg)
2017 Chronic Condition and Dual Special Needs Plans 06032016 P a g e | 13
3.5 Dual-Eligible Categories
3.6 Spend Down Explained
![Page 14: 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1 2017 Chronic Condition and Dual Special Needs Plans 1.](https://reader033.fdocuments.in/reader033/viewer/2022041615/5e3a83b637687e7712222958/html5/thumbnails/14.jpg)
2017 Chronic Condition and Dual Special Needs Plans 06032016 P a g e | 14
3.7 Medicaid Eligibility
Consumer Must (Slide Layer)
![Page 15: 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1 2017 Chronic Condition and Dual Special Needs Plans 1.](https://reader033.fdocuments.in/reader033/viewer/2022041615/5e3a83b637687e7712222958/html5/thumbnails/15.jpg)
2017 Chronic Condition and Dual Special Needs Plans 06032016 P a g e | 15
Dual Status (Slide Layer)
3.8 Consumer Characteristics
![Page 16: 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1 2017 Chronic Condition and Dual Special Needs Plans 1.](https://reader033.fdocuments.in/reader033/viewer/2022041615/5e3a83b637687e7712222958/html5/thumbnails/16.jpg)
2017 Chronic Condition and Dual Special Needs Plans 06032016 P a g e | 16
Prescription medicine help (Slide Layer)
Community Services (Slide Layer)
![Page 17: 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1 2017 Chronic Condition and Dual Special Needs Plans 1.](https://reader033.fdocuments.in/reader033/viewer/2022041615/5e3a83b637687e7712222958/html5/thumbnails/17.jpg)
2017 Chronic Condition and Dual Special Needs Plans 06032016 P a g e | 17
Low Income (Slide Layer)
State medical assistance (Slide Layer)
![Page 18: 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1 2017 Chronic Condition and Dual Special Needs Plans 1.](https://reader033.fdocuments.in/reader033/viewer/2022041615/5e3a83b637687e7712222958/html5/thumbnails/18.jpg)
2017 Chronic Condition and Dual Special Needs Plans 06032016 P a g e | 18
Disabled (Slide Layer)
3.9 Special Election Periods
![Page 19: 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1 2017 Chronic Condition and Dual Special Needs Plans 1.](https://reader033.fdocuments.in/reader033/viewer/2022041615/5e3a83b637687e7712222958/html5/thumbnails/19.jpg)
2017 Chronic Condition and Dual Special Needs Plans 06032016 P a g e | 19
3.10 Medicaid Eligibility Verification
3.11 Loss of Medicaid Eligibility
![Page 20: 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1 2017 Chronic Condition and Dual Special Needs Plans 1.](https://reader033.fdocuments.in/reader033/viewer/2022041615/5e3a83b637687e7712222958/html5/thumbnails/20.jpg)
3.12 Cost Sharing - Premiums
2017 Chronic Condition and Dual Special Needs Plans 06032016 P a g e | 20
3.13 Cost Sharing
![Page 21: 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1 2017 Chronic Condition and Dual Special Needs Plans 1.](https://reader033.fdocuments.in/reader033/viewer/2022041615/5e3a83b637687e7712222958/html5/thumbnails/21.jpg)
2017 Chronic Condition and Dual Special Needs Plans 06032016 P a g e | 21
3.14 Checkpoint (Drag and Drop, 10 points, unlimited attempts permitted)
Feedback when correct:
That's right! You matched all the terms correctly.
![Page 22: 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1 2017 Chronic Condition and Dual Special Needs Plans 1.](https://reader033.fdocuments.in/reader033/viewer/2022041615/5e3a83b637687e7712222958/html5/thumbnails/22.jpg)
2017 Chronic Condition and Dual Special Needs Plans 06032016 P a g e | 22
4. DSNP Case Study 4.1 Case Study
![Page 23: 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1 2017 Chronic Condition and Dual Special Needs Plans 1.](https://reader033.fdocuments.in/reader033/viewer/2022041615/5e3a83b637687e7712222958/html5/thumbnails/23.jpg)
2017 Chronic Condition and Dual Special Needs Plans 06032016 P a g e | 23
4.2 Case Study Conversation
4.3 Case Study Questions Q1 Correct (Slide Layer)
![Page 24: 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1 2017 Chronic Condition and Dual Special Needs Plans 1.](https://reader033.fdocuments.in/reader033/viewer/2022041615/5e3a83b637687e7712222958/html5/thumbnails/24.jpg)
2017 Chronic Condition and Dual Special Needs Plans 06032016 P a g e | 24
Q1 Incorrect (Slide Layer)
Q2 Correct (Slide Layer)
![Page 25: 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1 2017 Chronic Condition and Dual Special Needs Plans 1.](https://reader033.fdocuments.in/reader033/viewer/2022041615/5e3a83b637687e7712222958/html5/thumbnails/25.jpg)
2017 Chronic Condition and Dual Special Needs Plans 06032016 P a g e | 25
Q2 Incorrect (Slide Layer)
Q3 Correct (Slide Layer)
![Page 26: 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1 2017 Chronic Condition and Dual Special Needs Plans 1.](https://reader033.fdocuments.in/reader033/viewer/2022041615/5e3a83b637687e7712222958/html5/thumbnails/26.jpg)
2017 Chronic Condition and Dual Special Needs Plans 06032016 P a g e | 26
Q3 Incorrect (Slide Layer)
Q4 Correct (Slide Layer)
![Page 27: 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1 2017 Chronic Condition and Dual Special Needs Plans 1.](https://reader033.fdocuments.in/reader033/viewer/2022041615/5e3a83b637687e7712222958/html5/thumbnails/27.jpg)
2017 Chronic Condition and Dual Special Needs Plans 06032016 P a g e | 27
Q4 Incorrect (Slide Layer)
Q5 Correct (Slide Layer)
![Page 28: 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1 2017 Chronic Condition and Dual Special Needs Plans 1.](https://reader033.fdocuments.in/reader033/viewer/2022041615/5e3a83b637687e7712222958/html5/thumbnails/28.jpg)
2017 Chronic Condition and Dual Special Needs Plans 06032016 P a g e | 28
Q5 Incorrect (Slide Layer)
Q6 Correct (Slide Layer)
![Page 29: 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1 2017 Chronic Condition and Dual Special Needs Plans 1.](https://reader033.fdocuments.in/reader033/viewer/2022041615/5e3a83b637687e7712222958/html5/thumbnails/29.jpg)
2017 Chronic Condition and Dual Special Needs Plans 06032016 P a g e | 29
Q6 Incorrect (Slide Layer)
5. CSNP Overview 5.1 Consumer Characteristics
![Page 30: 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1 2017 Chronic Condition and Dual Special Needs Plans 1.](https://reader033.fdocuments.in/reader033/viewer/2022041615/5e3a83b637687e7712222958/html5/thumbnails/30.jpg)
2017 Chronic Condition and Dual Special Needs Plans 06032016 P a g e | 30
Want To Reduce (Slide Layer)
Multiple Providers (Slide Layer)
![Page 31: 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1 2017 Chronic Condition and Dual Special Needs Plans 1.](https://reader033.fdocuments.in/reader033/viewer/2022041615/5e3a83b637687e7712222958/html5/thumbnails/31.jpg)
Will Benefit Costs (Slide Layer)
2017 Chronic Condition and Dual Special Needs Plans 06032016 P a g e | 30
Benefit Management (Slide Layer)
![Page 32: 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1 2017 Chronic Condition and Dual Special Needs Plans 1.](https://reader033.fdocuments.in/reader033/viewer/2022041615/5e3a83b637687e7712222958/html5/thumbnails/32.jpg)
5.2 Special Election Periods
2017 Chronic Condition and Dual Special Needs Plans 06032016 P a g e | 31
5.3 In-Network Providers
![Page 33: 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1 2017 Chronic Condition and Dual Special Needs Plans 1.](https://reader033.fdocuments.in/reader033/viewer/2022041615/5e3a83b637687e7712222958/html5/thumbnails/33.jpg)
2017 Chronic Condition and Dual Special Needs Plans 06032016 P a g e | 32
5.4 Chronic Condition Verification Process
5.5 Chronic Condition Verification Process Tips
![Page 34: 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1 2017 Chronic Condition and Dual Special Needs Plans 1.](https://reader033.fdocuments.in/reader033/viewer/2022041615/5e3a83b637687e7712222958/html5/thumbnails/34.jpg)
2017 Chronic Condition and Dual Special Needs Plans 06032016 P a g e | 33
Consumer Assistance (Slide Layer)
Agent Responsibilities (Slide Layer)
![Page 35: 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1 2017 Chronic Condition and Dual Special Needs Plans 1.](https://reader033.fdocuments.in/reader033/viewer/2022041615/5e3a83b637687e7712222958/html5/thumbnails/35.jpg)
2017 Chronic Condition and Dual Special Needs Plans 06032016 P a g e | 34
5.6 Checkpoint Q1 Correct (Slide Layer)
Q2 Correct (Slide Layer)
![Page 36: 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1 2017 Chronic Condition and Dual Special Needs Plans 1.](https://reader033.fdocuments.in/reader033/viewer/2022041615/5e3a83b637687e7712222958/html5/thumbnails/36.jpg)
2017 Chronic Condition and Dual Special Needs Plans 06032016 P a g e | 35
Q3 Correct (Slide Layer)
Q4 Correct (Slide Layer)
![Page 37: 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1 2017 Chronic Condition and Dual Special Needs Plans 1.](https://reader033.fdocuments.in/reader033/viewer/2022041615/5e3a83b637687e7712222958/html5/thumbnails/37.jpg)
2017 Chronic Condition and Dual Special Needs Plans 06032016 P a g e | 36
Q5 Correct (Slide Layer)
6. CSNP Case Study 6.1 Case Study Conversation
Notes:
![Page 38: 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1 2017 Chronic Condition and Dual Special Needs Plans 1.](https://reader033.fdocuments.in/reader033/viewer/2022041615/5e3a83b637687e7712222958/html5/thumbnails/38.jpg)
2017 Chronic Condition and Dual Special Needs Plans 06032016 P a g e | 37
6.2 Case Study Question (Multiple Choice, 10 points, 1 attempt permitted)
7. Wrap Up 7.1 Wrap Up
![Page 39: 2017 Chronic Condition and Dual Special Needs …...2017 Chronic Condition and Dual Special Needs Plans 06212016 P a g e | 1 2017 Chronic Condition and Dual Special Needs Plans 1.](https://reader033.fdocuments.in/reader033/viewer/2022041615/5e3a83b637687e7712222958/html5/thumbnails/39.jpg)
2017 Chronic Condition and Dual Special Needs Plans 06032016 P a g e | 38
8. Resources 8.1 Resources
9. Navigation 9.1 Navigation