Good Samaritan Working with PACE to Provide Insurance Assistance to Patients

Good Samaritan and PACE Community Action Agency have recently started working together to provide a Health Care Navigator to patients at Good Samaritan’s Primary Care Clinic.

Health Care Navigators are certified by both the state and federal government through training and testing. Once certified, navigators are competent to assist consumers to obtain insurance by evaluating their individual needs, usually through the Marketplace, Medicaid, or HIP 2.0. Individuals sign a consent form to release their information to the navigator. No personal information, other than name and telephone number, is kept by the navigator for enrollment purposes only.

Patients of the Primary Care Clinic can be assisted, with no fee, by the navigator through the enrollment process after their appointment at the clinic. The navigator explains the options available to the consumer based on their information. The consumer then chooses which plan they feel will meet their needs and enroll. The navigator will then tell the consumer what to expect next, such as receiving an eligibility notice. Consumers are directed to contact their navigator if they have any questions with any post enrollment issues.

We partner with most organizations throughout our service area” stated Bertha Proctor, CEO of PACE Community Action Agency. “While in discussion with Rob McLin, we agreed that this service is beneficial for individuals in our community. Good Samaritan and PACE serve some of the same individuals, and both organizations work to improve the lives of those in our community.”

Navigators play a vital role in helping consumers prepare paper and electronic applications to establish eligibility and to enroll in health insurance coverage through the Marketplaces and potentially qualify for an affordable insurance program. Patients have someone they can go to for accurate and timely information; someone they can go to for assistance in the application process as well as application follow-up. “Many of the patients seen at the Primary Care Clinic are underinsured or do not have any health insurance at all,” stated Rob McLin, President and CEO of Good Samaritan. “We want to help our patients understand everything they need to know about their health care benefits. The Navigator is able to sit with patients one-on-one and discuss all the options that are available.”

The PACE Navigator provides assistance to those who enroll in insurance and HIP. Most individuals will receive “the letter” from Indiana Medicaid requesting additional information for verification purposes. If this information is not returned to Medicaid within a set time frame, that application is denied and it is as though they never applied. The Navigator helps the consumer understand what is being requested in “the letter”, where they can obtain this information if they do not have it, how the individual can mail or fax it to Medicaid at no charge.

“Our patients have really benefited from having the Navigator at the clinic once a week,” said Jane Russell, Director of Continuum of Care. “We are still in the early stages of this partnership with PACE, but I am excited to see what the future holds.”

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