1. Patient Benefits Coordinators

2. Winnebago Indian Health Service Winnebago and Omaha Tribes of Nebraska Over 10,000 members Nebraska, Iowa, and South Dakota 3. Patient Benefits Coordinator Enroll all eligible service unit population withalternate resources Serve as a patient advocate for those who needassistance when applying for an alternate resourceprogram Provide education and training to staff aboutalternate resource programs and changes in thehealthcare industry Act as a liaison between federal, state, local, andtribal agencies 4. Contract Health Services CHS funds are limited to the medical or dentalservices considered medically necessary andlisted within the established Area IHSmedical/dental priorities. An individual must apply for and use all alternateresources that are available and accessible, such as Medicare A and B, state Medicaid,state or other federal health program, privateinsurance, etc. The IHS facility is also considered a resource, andthe CHS funds may not be expended for servicesavailable at IHS facilities. I H S is the "payor of last resort" of personsdefined as eligible for CHS 5. Third Party EligibilityFY 2011 985 Medicare Part A Medicare Part B2845 845 Medicare Part D Medicaid 367 6. 11 BenefitsMedicarePart A - Hospital CoveragePart B - Medical InsurancePart C - Medicare Advantage PlansPart D - Prescription Drug Plans 7. Medicaid and CHIPEligibility Requirements Disabled Individuals Pregnant Woman Children And some parents 8. Disability, Retirement, Widows Benefits, and Survivors Benefits Age Education Work Experience Physical/Mental Conditions 9. Five Step Process Work Activity Medical severity of your impairment Medical severity of your impairment meetsthe duration requirement and equals one ofour listings through the SSA Residual functional capacity and your pastwork Age, education, and work experience 10. Hepatitis C Chronic Liver Disease with Liver Cell Necrosis Chronic Hepatitis and Alcoholic LiverDisease Chronic Viral Hepatitis caused byHep C virus Gastrointestional Hemorrhaging fromvarices, requiring transfusions Ascites of the hydrothorax Spontaneous Bacterial peritonitisinfection Renal Failure associated with Chronicliver Disease Hypoxemia associated with ChronicLiver Disease Neuropsychiatric disordercharacterized by abnormal behavior End-Stage Liver Disease 11. Human ImmunodeficiencyVirus Bacterial infections Fungal infections Protozoan or helminthic infections: Viral infections Malignant neoplasms Hematologic abnormalities Neurological abnormalities 12. Monthly Exception Report Patients under 18 without third-partycoverage who may be eligible for theMedicaid/CHIP Program Patients over 65 without third-partycoverage who may be eligible forMedicare A, B, and Part D 13. HOW CAN I/T/U PROVIDERS IMPROVE ON ACCESSING PUBLIC BENEFITS FOR THEIR COMMUNITIES Implement an Action Plan Keep statistics on your communities Provide regular education and training to your communities Be proactive rather than reactive Hold regularly scheduled meetings with your service area Report your progress with the local Tribal leadership Assist the elders if they require assistance, e.g. homevisits, application assistance, transportation, etc. Resources have promotional items made Training your outreach effectiveness depends on yourknowledge of programs and patience! 14. Useful Tools Exception Report Page 5 Appointment List Trainings 15. Referenceswww.ihs.govwww.ssa.govwww.cms.govwww.Medicare.govwww.Healthcare.govwww.wikipedia.com www.allsup.comFlute music by Robert Mirabal and Rare Tribal Mob