Governing for Results 2 - Washington State Digital Archives

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Department of Social and Health ServicesCustomers find out fast if they're 'in'Customers applying for the Healthy Options managed care program were notnotified of their acceptance until they received their medical identification cardweeks after enrollment. This often resulted in duplicate forms being submitted ortelephone calls from people trying to confirm their enrollment.A cross-agency team designed a notice to mail to clients within 48 hours ofconfirmation. To make it as distinctive as possible, a white window envelopewith a large "You're In" in red script was used on yellow letterhead.Results★ Customers are better informed.★ Calls related to enrollment have decreased by 68 percent from about 1100 amonth in June to 350 in November.★ Duplicate enrollments have decreased by 50 percent from more than 2000 inSeptember to 1000 in October.Team members: Selia Evans, Jacquie Howard, Carole Lawton, Michelle Senn,Seanne Sams, Richard Pannkuk, Dan Lehuta, Andree Balzer, Elizabeth Burris,David Hanig, Norma Leavitt, Diane Weeden, and Pat White.CONTACT: Bill Wegeleben (360) 902-0865 or Roberto Reyes-Colon (360) 586-208945
Department of Social and Health ServicesDuplicate payments eliminatedChildren's Administration (CA) staff is responsible for submitting authorization forMedicaid for children in foster and group care and those served by the AdoptionSupport Program. CA staff did not have easy access to information systems thatshow when children are correctly authorized for Medicaid and under which plan.Duplicate payments were resulting when children who were already authorizedon a Healthy Options plan entered foster care and were authorized on a fee-forserviceplan. This was creating billing problems for providers, and whenchildren were not correctly authorized for Medicaid, there were delays in medicalcare and filling prescriptions.Children’s Administration established a new work unit in the Medical AssistanceAdministration and a toll-free number for caretakers of children and health careproviders. The unit has access to both management information systems and willauthorize all Medicaid benefits for children in foster care.Results★ Duplicate medical payments have been eliminated, re-directing $94,500 inMedicaid payments so far this fiscal year.★ Medicaid hotline improves communication services and decreases providers’billing problems.Team members: Dinah Martin, Manning Pellanda, Bernice Dittmer, Viola Victor,Karen Chase, Virginia Johnson, Kim Simon, and Linda Churchill.CONTACT: Bill Wegeleben (360) 902-0865 or Dinah Martin (360) 902-799346
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Governing for Results 2 - Washington State Digital Archives

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