Certified Application Assistance Sites (CAAS)Training

Presented byLisa Sterling

CAAS Program Administrator

Course Goal Participants will gain a clearer understanding of

the processes, programs, and requirements of Medical Assistance Programs.

Participants will learn the expectations, and responsibilities of being a CAAS.

Participants will learn how the CAAS Program works in conjunction with other programs.

Our Mission

We oversee and operate Health First Colorado (Colorado Medicaid), Child Health Plan Plus (CHP+), and other public health care programs for Coloradans who qualify.

Improving health care access and outcomes for the people we serve while demonstrating sound stewardship of financial resources.

Discussion Topics Collaboration with Hospital Outstationing Program All about the CAAS Program

Participation Requirements Mandatory Training, Expectations Responsibilities Verifying Citizenship & Identity Documents

Best Practices Purpose of the Mapping Tool Additional Information Resources

CollaborationParticipating in the CAAS Program allows an agency the opportunity to also participate in the Department’s Hospital Outstationing Program.

The Hospital Outstationing Program is a grant funded program established by the Department which provides funds to eligible hospitals to offset the costs of offering Outstationing activities to individuals and families seeking financial assistance for health care services.

While this is a voluntary collaboration between the CAAS agency and the hospital, it does present an opportunity for the CAAS agency to be reimbursed for their eligibility services through the participating hospital.

• To provide assistance to consumers with navigating through the application process.

• To serve as a certified resource to verify documents, on behalf of the Department, for applicants.

• To provide local assistance to all members of the community seeking Medical Assistance benefits.

Purpose of CAAS

Participation Requirements

Complete a participation application – locations that wish to apply for more than one location, must complete a separate application for each location.

Adhere to the Department’s rules, regulations and agency letters.

Read and abide by all applicable HIPAA privacy and security requirements regarding health information as defined.

Submit your site’s quarterly report on time per the submittal dates listed on the reporting template.

Maintain certification and renew certification every two years.

CAAS Mandatory Training Process

Each staff member that will be providing application assistance or verifying citizenship and identity documents on behalf of the Department is expected to view this entire training presentation.

After viewing this presentation, each staff member must take the test included in the interactive CAAS Training presentation and score 95% or higher in order to be certified.

Each person will need to print their test results and send them to the CAAS Administrator in order to be issued a Certificate of Completion.

CAAS Staff ExpectationsReview all CAAS Program training materials and pass the interactive

CAAS Program test with a score of 95% or higher.

Assist all applicants or clients of the community presenting to your location.

Process and forward all Medical Assistance Program applications to a county, eligibility site or a Medical Assistance site within 5 business days.

Follow the application processes and guidelines as detailed in this training presentation.

CAAS Staff Expectations

Review the application while the applicant or client is still present to make sure it is complete.

Verify documents presented by an applicant or client using one of the processes identified in this presentation.

NEATLY write or stamp your CAAS identification information on all applications you assist with and all document(s) you verify.

CAAS Staff Expectations

Document and track productivity data for application assistance you provide, to be included in your site’s CAAS report submitted to the Department each quarter.

Encrypt all emails containing Protected Health Information (PHI), turn documents facedown, and never leave application documents out when you leave your desk.

Notify the CAAS Program Administrator of changes, concerns or issues pertaining to your site’s ability to operate effectively as a CAAS, such as address, phone number or staffing updates.

CAAS Quarterly Report

• HCPF requires documents received via email containing PHI to be encrypted

• Log all CAAS activity: Applications and/ or documents verified

SITE NAMESesame Street Children's Clinic Site

SITE NUMBER 1111PHONE 303-555-5555Reporting Qtrs HOSPITAL OUTSTATIONING SITES : In addition columns A-J please answer the 3 questions below Jan 1 - Mar 31 Due April 15 1. During the current quarterly reporting period, has your hospital experienced any major challenges providing the agreed upon Outstationing services?__________Apr 1 - Jun 30 Due July 15 2. Is there anything you would like us to know about, or do you need assistance in order to effectively provide Outstationing services?_______________________Jul 1 - Sep 30 Due October 15 3. If applicable, please provide a brief explanation of any changes to your Outstationing activities that have / will change the grantees level of participation:______Oct 1 - Dec 31 Due January 15

App. Intake Date

Head of Household (Full Name)

SSN or PEAK Tracking #

Please √ if Undocumented

Intake Mode (PEAK, walk-In, paper,

fax, etc.)

Application Complete

Y/N*

*Comments (missing info or documentation)

Outgoing or PEAK Date Forwarded to Person Assisting with

Application

APPLICATION ASSISTANCE SITE QUARTERLY ACTIVITY REPORT *You must submit a report each quarter even if no assistancewas provided. Please check here____ and submit if No assistance was provided during the reporting quarter .

# of applicants assisted during: current QTR____ YTD______

Reports are to be submitted for EACH site. For HIPAA compliance reports may be submitted by encrypted email to hcpf_assistancesites@state.co.us OR if you are unable to encrypt your email you may fax your report(s) to: 303-866-2082

To remain in compliance with Timely Processing Requirements, your agency acknowledges and agrees to forward ALL (complete and incomplete) applications to the county, eligibility site, or Medical Assistance site within 5 business days .

CAAS Administrator: Lisa Sterling (P) 303-866-2434, (F) 303-866-2082, Email: lisa.sterling@state.co.usPresumptive Eligibility Administrator: Georgann Garcia, (P) 303-866-3544, (F) 303-866-4517, Email: georgann.garcia@state.co.usHospital Outstationing Administrator: Brian Knight,(P) 303-866-4221, (F) 303-866-4517, Email: brian.knight@state.co.us

Application Assistance

Timely Forwarding of Applications to Appropriate Counties

Quarterly Reporting

Employee Information Sheet

Recertification

CAAS RESPONSIBILITIES

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QUESTIONS

VERIFYING CITIZENSHIP AND IDENTITY DOCUMENTS

Citizenship and Identity Requirement

Medical Assistance programs still require proof of an applicant’s identity, U.S. Citizenship or lawful residency for non-U.S. citizens.

Counties and Medical Assistance (MA) sites may be able to verify an applicant’s citizenship and identity via electronic interface.

CAAS agencies do not have access to the electronic interfaces when providing application assistance and are still required to verify and forward citizenship and identity documents if presented by an applicant. You must forward all documents within 5 business days.

CAAS agencies shall not hold an application for any reason and are required to forward all applications (complete or incomplete) to a county, eligibility or MA site within five (5) business days.

Acceptable Documents for Proof of Citizenship and Identity

U. S. Passport (current or expired)

Certificate of Naturalization or Citizenship

Indian Tribal Document

NOTE: Photocopies presented by the applicant to a site are notacceptable proof of citizenship or identity verification

Acceptable Identity DocumentsOne (1) document from Primary list OR Two (2)

documents from Secondary ListPRIMARY LIST (expired documents are not acceptable)

• Alien Registration Receipt/Permanent Resident Card• Certificate of U.S. Citizenship• Colorado Department of Corrections ID card• CO Temporary Driver’s License Form (with hole-punched

Driver’s License)• Employment Authorization Card (I-766)• Foreign Passport• Photo Driver’s License• Photo ID Card (DMV)• School, University or College ID Card (must be current)• Temporary Resident Card• UNITED STATES:

B1/B2 Visa card with I-94 Certificate of Naturalization Citizenship ID Card (I-197) Military ID Card Passport

SECONDARY LIST

• Acknowledgment of Paternity document

• Court order of adoption or name change

• DD-214

• Hospital birth worksheet (for infants under 6 months)

• Colorado Hunting, Fishing, Craft or Trade or Pilot’s License (CURRENT)

• IRS-TIN card or Mexican voter registration card

• Merchant mariner card

• Social Security, Medicare or Social Services Card (Medicaid, WIC)

• State or federal prison or corrections card

• Tribal ID Card

• Work ID, Paycheck Stub (within 3 months), or W-2

• UNITED STATES: Birth Certificate of Applicant Divorce Decree Marriage license Motor vehicle registration or title Selective Service Card Weapon or gun permit

• Any document listed on the Secondary list expired 6 months or less

EXEMPT from Proof of U.S. Citizenship Requirement

Newborns whose mother is on Health First Colorado (Medicaid) or CHP+ at time of birth

SSI and SSDI recipients

Medicare recipients

Foster children

Presumptive Eligibility (PE) Clients

CAAS Verification Process Option 1

Photocopy the original or certified copy of document(s)

Stamp or neatly write the following CAAS information on each photocopied document

• Agency’s name as it appears in the Mapping Tool• Name and signature of staff who viewed documents• Agency’s address• Agency’s phone number• Date of document verification

Write “verified original” above agency’s information

Write the PEAK tracking number on each document if application was submitted online

Submit application and/or all verified documents to a county, eligibility or MA site within 5 business days

CAAS VERIFICATION PROCESS OPTION 2

VERIFIED ORIGINAL(S) _√_ PEAK TRACKING # ________________________

Accurate and Complete CAAS Process

Make sure the applicant has signed page 11 of the application, and if appropriate page 3 of WORKSHEET D

Attach a note identifying missing or incomplete documentation

Date stamp all applications processed and forwarded by your site

Do not date stamp applications for applicants choosing to hand deliver

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Best Practices Cont..

•Stamp or write your entire CAAS site name and number on all CAAS related documents and communications

• Ensure you read periodic messages emailed to you informing you of important changes, updates and training opportunities that pertain to the CAAS Program.

• Provide at least one (1) additional back-up contact(s) in the event your site’s main contact changes or is unavailable

•Set a reminder to renew your CAAS certification approximately 30 days before your current certification expires

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Best Practices Cont..

•Advise members that all communications will be sent directly to the address they provided and of the importance of updating changes in PEAK or notifying the county of address or phone number changes

•Explain timely processing expectations, to the member and provide the member with a list of missing documents, the contact information for your site, and the applicable county office , or Medical Assistance site.

Purpose of the Mapping Tool*A Resource For*

Community members and partners to locate application assistance sites

Counties needing to contact or locate a CAAS, Presumptive Eligibility (P.E.) or Medical Assistance (M.A.) site

Counties to verify if a site is authorized by the Department to provide application assistance and verify citizenship and identity documents

Mapping Toolhttp://www.colorado.gov/apps/maps/hcpf.map

QUESTIONS

Who Does Medical Assistance Programs Serve?

Citizens Qualified Non-Citizens

Unqualifiednon-citizens facing emergency medical

situations

People with limited income

& resources

What are the Types of Medical Assistance Programs Available?

Health First Colorado

(Medicaid)

Child Health Plan Plus (CHP+)

MAGI (Modified Adjusted Gross Income) and NON MAGI

What is Health First Colorado (Medicaid) & Who Qualifies?

Health First Colorado is a public health insurance program for Coloradans who qualify; typically individuals or families with limited income and resources.

Children, pregnant women, parents & caretakers, people with disabilities, & adults can all potentially qualify. There are no enrollment fees and co-pay amounts vary depending on income.

It is also important to note that while the co-pays are low, there are several populations who are not required to pay co-pays at all including:• Children • Pregnant women• American Indian/Alaska Natives

What is CHP+ &Who Qualifies?

• Applicants with household income under 260% of the Federal Poverty Level (FPL)

• Colorado residents• Permanent legal residents who have had an Alien Registration

number for at least five (5) years, a refugee or asylee• Applicants not eligible for Health First Colorado (Medicaid)• Applicants who do not have other health insurance

How are Health First Colorado & CHP+ Different?

• No enrollment fee• Members can be covered

under another insurance policy at same time

• Income limits lower than those for CHP+

• All populations potentially eligible

• Annual enrollment fee• Members cannot be

covered under another insurance policy at same time

• Income limits higher than those for Health First Colorado (Medicaid)

• Only covers children & pregnant women

Health First Colorado CHP+

MAGI & Non-MAGI

MAGI Populations• Age 64 & younger• Not eligible for Medicare• Low income:

– Children– Adults– Pregnant Women– Parents or Caretakers of a

Health First Colorado (Medicaid) eligible child that is under the age of 19

Non-MAGI Populations• Low-income individuals who

meet any of the following: – Age 65+– Blind– Disabled by Social Security

Administration (SSA) standards

The Difference

Applying for Benefits -Application Requirements

• Name, address, & contact information• Social Security numbers (or document numbers) for each member of the

household that will be covered• Birth dates• If someone in the home is pregnant, the due date & number of babies for

that pregnancy• Information & policy numbers for health insurance plans currently

covering members of the applicant’s household• Asset & expense information for the household if anyone in the home is

disabled

Who Should Be Included On an Application?

• Member• Member’s spouse• Member’s children under age 19 who live with them• Anyone on member’s federal income tax return

–This could include children over age 19, even if they do not live with them

• The member’s unmarried partner who needs health coverage• Anyone else under age 19 who the member takes care of & lives

with the member

Resource for CAAS Agency

Find this @ COhealthinfo.com/FAQs/

Frequently Used Phone Numbers

Connect for Health Colorado(C4HCO)

Website: getcoveredco.org or ConnectforHealthCo.com

Phone: 1-855-PLANS-4-YOU (1-855-752-6749)TTY/TDD 1-855-346-3432

Health First Colorado Client Services

Website: colorado.gov/hcpfPhone: 303-866-3513 or 1-800-221-3943

Fax: 303-866-4411

MedicareWebsite: medicare.gov

Phone: 1-800-MEDICARE (633-4227)

State Health Insurance Assistance Program (SHIP) Phone: 1-888-696-7213

Social Security Administration

Website: ssa.govPhone: 1-800-772-1213

Website: ChpPlus.orgPhone: 303-751-9051 or 1-800-414-6198

State Managed Care Network (CHP+)

Eligibility Site Program Contacts

Presumptive Eligibility (PE) Site Program:Georgann Garcia * PE Specialist

303-866-3544 * Georgann.garcia@state.co.us

Hospital Outstationing Program:Brian Knight * Hospital Outstationing Contract Mgr.

303-866-4221 * brian.knight@state.co.us

Medical Assistance Site Program:Monica Owens * M.A. Site Program Manager

303-866-2286 * monica.owens@state.co.us

Resources for Applicants

• FAQ’s Online @ Colorado.gov/hcpf/member-faqs• Call or visit your county Department of Human / Social

Services• Contact Health First Colorado Customer Contact Center:

–Toll Free: 1-800-221-3943–TDD: 1-800-659-2656

• Contact CHP+ Customer Service:–1-800-359-1991–CHPPlus.org

• peakoutreach@bouldercounty.orgPEAK website training or questions

• Colorado.gov/health (>select FAQs) Colorado.gov/HCPF

Application and general benefit Information

• 1-800-359-1991Submitted Medical Assistance application status

• 1-800-221-3943/ TDD 1-800-659-2656General Medical Assistance benefits information

• 1-800-536-5298Food or cash application assistance

• ConnectforHealthCO.com• 1-855-752-6749/ TDD 1-855-346-3432Connect for Health Colorado

• CBMS.Help@state.co.usPEAK technical issues such as an error message

Help/Resources

Medical Assistance by phone call:

• 1-800-221-3943• TDD: 1-800-659-2656

Can apply in person at:• County Departments• Medical Assistance

(MA) sites• Certified Application

Assistance Sites (CAAS)

To apply by mail or fax:• Print out application

online• Or request a printed copy

Colorado.gov/hcpf/form/paper-application-request

What Is PEAK?

PEAK FACTS

Benefits of the Mobile App

Visit Colorado.gov/PEAK to get started!

To learn more about what you can do with the PEAKHealth mobile app, visit Colorado.gov/HCPF/PEAKHealth.