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Uninsured Patient Access to WUSM Providers. CMC Presentation February 21, 2013. Background . Prior to July 2012, uninsured patients that did not qualify for MO HealthNet coverage were referred to ConnectCare for specialist services .
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Uninsured Patient Access to WUSM Providers CMC Presentation February 21, 2013
Background • Prior to July 2012, uninsured patients that did not qualify for MO HealthNet coverage were referred to ConnectCare for specialist services. • Services that ConnectCare could not provide were referred to WUSM specialists for treatment. • If the service was referred from ConnectCare, it was reimbursed by ConnectCare.
Gateway to Better Health • Block Grant sponsored by the St. Louis Regional Health Commission effective July 1, 2012. • Not all patients qualify for GBH. • Direct referrals from FQHCs.
Uninsured Patient Referrals • How do WUSM departments work with physician referrals when the patient is uninsured? • What information do we give to referring physicians? • How do we serve uninsured patients while still remaining financially viable?
Current Patient Flowchart • Is reason for visit appropriate for specialty? • Does the patient have insurance? • Can the patient pay required deposit? • Is visit urgent?
Referring Physician Communication • WUSM provides any needed urgent care for patients with no regard to their ability to pay. • WUSM provides care to uninsured patients with medically necessary conditions based on the capacity of the department to see these patients. • All patients needing care beyond office or consultation services will be evaluated for financial status.
