CONWAY — When a patient is admitted to the hospital, the last thing to worry about should be whether or not they have insurance coverage to pay for their care.
That’s the premise behind a new Access to Care program at Memorial Hospital and all MaineHealth facilities.
The hospital has recently named Melissa Bartlett as the coverage case manager who will help patients navigate the many options available and ensure they are able to access what they need, so they can focus on getting better.
Bartlett is already a familiar face at Memorial, having joined the hospital as a patient financial advocate in 2013. In that role, she assisted patients with billing questions and other financial issues. Now, she has an expanded role that will provide even more resources for community members who have questions about Medicaid, Health Insurance Marketplace insurance plans and other financial assistance.
She said, “I’m here to help uninsured and underinsured people explore what eligibility they qualify for, including programs through N.H. Medicaid or the Marketplace.
“I help them fill out forms and submit necessary documents. Some folks don’t have the follow-through to get coverage, and I’m here to help. It can be overwhelming. I want to help people tackle that piece of the puzzle.”
The program allows the coverage case manager to meet with the patient at the bedside. If they are admitted and do not have insurance coverage, Bartlett is notified and is dispatched to Memorial’s inpatient unit.
She said, “I’m notified by case management of a patient who doesn’t have insurance or may need a long-term care facility. I’ll go down and fill out the application with them and submit it. At the same time, I’m reaching out for a free care application or long-term payment options that MaineHealth offers that’s income based.”
While much of her time will be spent helping patients who have been admitted to the hospital, she is also available to help patients receiving outpatient services. She gave the recent examples of a patient receiving cancer care in the hospital oncology center who reached out for assistance and pregnant moms-to-be who want coverage for their prenatal care and services from the Family Birthing Center.
Another outpatient service she can support includes the breast and cervical cancer program, which covers free mammogram and Pap smears for women who meet income eligibility guidelines. She can also coordinate access to the newly announced MedAccess program which helps patients pay for their prescriptions.
She said, “My goal is to focus on the coverage needs for each person’s unique health-care situation.”
Another important duty for the coverage case manager is acting as acertified application counselor to help patients apply for insurance plans through the Affordable Care Act’s Marketplace.
Open enrollment for ACA plans is going on now through Dec. 15, with coverage beginning Jan. 1, 2020.
“Anyone can come to me even if they are not our patient — self-employed, or those not otherwise eligible for coverage through an employer or the state can apply,” Bartlett said..
“There are options from Anthem and AmBetter. As a certified application counselor, I can help people review their options. I helped a self-employed individual yesterday, and he was able to find a plan and understand what subsidies he might qualify for,” she said.
Bartlett new role is a natural transition from the work she had been doing helping patients as a financial advocate. Now she can focus exclusively on access to coverage.
William Bullock, Memorial’s revenue cycle director, said: “MaineHealth has initiated an Access to Care program which assists uninsured and underinsured patients with obtaining coverage. They are placing a resource locally at each affiliate to perform these functions. Bartlett already does a lot of this work today, but this new role will be a much more focused approach to helping our community members get coverage. Bartlett is extremely talented in this niche and this is a great opportunity for her and Memorial Hospital.”
For more information, contact Bartlett Bartlett at (603) 356-5461 or online at www.memorialhospitalnh.org.
For more information on Health Insurance Marketplace Open Enrollment and to view and compare plans and prices by using an estimator tool, go to healthcare.gov/see-plans.