Project name:



Dear Care Coordination Partners,

Beginning September 2019, Blue Cross and Blue Shield of Minnesota will be offering our community (non-institutional) SecureBlue (MSHO) members the opportunity to complete a colorectal cancer screening and/or kidney disease screening kits in the comfort of their own home. Our independent vendor partner, Home Access Health, will be engaging approximately 1,000 MSHO members to participate by sending an initial engagement mailer that describes the initiative and next steps. See attached sample. Members will be identified to receive a kit if they are not compliant for the colorectal cancer screening or kidney disease monitoring measure as of May 1st, 2019.

Members will be given the choice to opt-out of receiving kit(s) if they do not wish to participate or feel that it’s not medically appropriate for them by calling the opt-out phoneline and using their member specific access code found in their engagement mailer. They must call the opt-out line at (888) 321-0396 by September 10th, 2019. Members who don’t opt out by September 10th will receive the kit(s) between September 16th – September 19th. Once kit(s) are received, members can complete samples, fill out the patient information card, adhere it to their sample and send back directly to Home Access using the prepaid envelope. They can drop it in any U.S. Postal Service mailbox. Home Access will process the results within 3-4 weeks. Once the results are complete, Home Access will notify the member and their identified primary care provider of results.

Members can return the completed kit(s) anytime from when received through August of 2020 but will be encouraged to complete before October 31st, 2019.

Kit results will be sent to the member and the provider that the member identifies as their primary care.

Targeted Population: Medicare Advantage (MAPD) and Secure Blue (MSHO) members who have an open STAR gap for Colorectal Cancer and/or Diabetes Kidney Disease monitoring. This is approximately 16,000 members.

Goal: Our goal is to improve health outcomes of members by encouraging identified members who have an open gap for Colorectal Cancer Screening or Kidney Disease Monitoring to be screened through in-home test kits.

Services Provided: Home Access will mail in-home kits directly to identified members’ homes. Instructions are included with kits.

1. Stool Sample kit – Colorectal Cancer Screening.

2. Urine Microalbumin kit (urine sample) – Diabetes Kidney Disease monitoring.

3. Member could also have both kits sent if both screenings are needed.

Results Process:

Normal result

1. Home Access will send a “Results Notification Letter” to the member and the member’s Primary Care Provider (PCP) within 2 business days of results being available via us mail.

Abnormal result

1. Home Access will call member within 1 business day of results being available. Home Access will make up to 3 phone attempts to speak with member.

a. If member is reached, primary care provider is verified:

i. Home Access will send copy of result via fax to primary care provider.

b. If member is reached, but does not have primary care provider:

i. Home Access will help in finding a primary care provider.

1. If member agrees to assistance:

a. Home Access will give member BCBSMN toll-free Customer Service number.

2. If member declines assistance:

a. “Alert Letter” will be sent via Certified US Mail to member home.

c. If member is not reached, Home Access will send certified “Alert Letter” to member’s home and the Primary Care Provider (PCP) the member identified on the patient info card

Timeline:

• 08/27/19: Initial engagement mailer with opt-out instructions sent to members

• 09/10/19: last day for members to call opt-out line (888) 321-0396 if they do not want to receive the kit(s). Members should have their unique access code ready, found in the initial engagement mailer

• 09/16/19: If member opts-out of program, they will receive a final letter encouraging them to call Home Access through August 12th, 2020 if they change their mind and do want to participate

• 09/16-09/19/19: Kits shipped to participating members

• 10/14/19: If Home Access hasn’t received member’s completed sample by 9/30, Home Access will send the member a reminder postcard that will be received by the member on 10/14

• 10/31/19: encouraged kit completion date

• 8/12/20: This is the final day for completed samples to be sent to Home Access for processing

Grievance Process:

1. Members can call Customer Service (CS) if they have a grievance with this initiative by calling the phone number located on back of member card. Phone number will correlate with what plan member is in.

2. CS will inform the BCBSMN Project Manager of any member grievance via email. CS will outreach member and resolve issues.

3. If member contacts Signify Health directly for grievances, they will send information directly to the BCBSMN Project Manager who will forward to correct contact in CS to resolve.

Benefit (claims) Affect: This program will not impact eligible members benefits and they will not incur cost. Home Access home kit completion will not be processed as a claim. This program will not affect any type of preventive screening claim. Please see attached HEDIS measure for further clarification.

Contact: If a member has questions about the program or the kits, direct them to Home Access: 1-800-442-5650. They are available Monday through Friday between 6 a.m. and 7 p.m.

If there are internal questions, please contact Jenna Buckner (Jenna.Buckner@).

FAQ:

1. Why am I receiving this?

a. Blue Cross is committed to making it easy for members to get the care they need. You have been identified as having a gap in care for colorectal cancer screening and/or kidney monitoring in the time of 1/1/19-5/1/19. Regular screenings can help detect problems at an early stage so you can continue to live life to the fullest.

2. I already did this, why am I getting the kit(s) again?

a. The colorectal cancer screening and/or kidney monitoring screenings are yearly screenings that are available to you.

b. If you’ve already completed these screenings between 1/1/19-5/1/19 and you’re still receiving the kit(s), it’s possible that you completed through a different program and we did not get the record of this. You may have completed through your primary care provider. Many Care Systems also provide this service to their members. Discuss with your primary care provider if this program is right for you.

c. If you completed the screening after 5/1/19 we did not receive the record in time to not send you a kit(s) for this year.

3. Are there claims filed for kit provided?

a. No, member will not be billed for these screenings.

4. How can a member opt-out of the program?

a. If a member is not interested in participating in this program, they can opt-out of receiving the kit(s) by calling the opt-out phoneline (1-888-321-0396) and using their member specific access code that they received in the initial engagement mailer on August 27th. Member’s must opt out by September 10th in order to not receive the kit(s).

i. If they miss the opt-out deadline, they will receive the kit. Member can choose if they want to complete the kit.

b. If a member doesn't want to be contacted for any BCBSMN program moving forward, they can be added to the Do Not Call list (DNC list). Please follow the below process:

o BCBS Customer Service rep send's email to the Project Manager, Jenna Buckner, containing:

▪ Member's ID

▪ First and Last name

▪ Member's Date of Birth

o Project Manager adds member info to the Do Not Call list.

o The member will be removed from the call list 5-10 business days later

****please note that if a member doesn’t want to receive the kit(s) the member must additionally opt-out of the program by calling the opt-out phoneline (1-888-321-0396) and using their member specific access code that they received in the initial engagement mailer on August 27th. They must opt out by September 10th.

5. What is the expiration date for the kits?

a. It’s based on manufacturing date (different lots expire at different times), majority within 24 months

b. HAHC does not ship kits with less than 6 months until their expiration date

6. What will be sent to members?

a. Initial Engagement Mailer (with opt-out instructions): Starting, 8/27/19 members will be sent an initial engagement mailer that describes the program and gives them information on how to opt-out of the program if not interested. Members have until 9/10 to opt-out of the program. If they have not opted-out by this time, the member will receive the kit(s)

b. Final Signoff Letter: If members chose to opt-out of the program they will receive one final letter around 9/16 that reframes the program and provides an opt-in phone number for them to request the kit(s) if ever interested.

c. Kit(s) and Welcome Letter: Beginning 9/16-9/19, members who do not opt out of the program will receive the in-home test kits and welcome letter. Letter includes instruction on how to complete kit(s). It will also include a blank patient info card that the member needs to complete. Needed information includes name of their primary care provider (PCP) and member’s identifying information for processing the kit(s).

d. Reminder Postcard: Members will be sent a reminder postcard on 10/14 if kit is returned by 9/30.

e. Hold Letter: Letter will be sent to member if kit(s) are untestable. Kits may be untestable for reasons like expired sample or insufficient member information. Member will only receive this letter if member is not reached via phone outreach first.

f. Replacement Letter: Letter and kits will be sent if member request a new kit.

g. Result Letters: Member results will be sent to member and their primary care provider (PCP) 3-4 week’s after completed test is received by Home Access

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In-home Annual Wellness Visit & Bone Scans 2019 Signify Health

MAPD & MSHO

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2019 In-home Test Kits

Home Access

Secureblue MSHO

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