HIPAA

D-SNP Plans & Contact Prior to Eligibility Date

  • 1.  D-SNP Plans & Contact Prior to Eligibility Date

    Posted 09-23-2020 08:31 AM
    Question for other health plans with dual eligible special needs plans (D-SNP). Do you allow staff to contact "potential" members prior to their eligibility date? For instance, if we learn a person is eligible for the D-SNP program on 1/1/2021, would we be able to contact them in the few weeks prior to their eligibility date to obtain any necessary PHI authorizations or Powers of Attorney (care coordination)? Many people on these plans are indigent and need assistance leading up to the eligibility date. If you allow this contact prior to the eligibility date, what are you using as a regulation or rule to support the outreach prior to date of eligibility? Thanks in advance for your input.

    Sincerely,

    Allie




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    Allison Wein
    Privacy Specialist
    Security Health Plan of Wisconsin, Inc.
    1515 N. St. Joseph Avenue
    Marshfield, WI 54449
    715.221.9414
    wein.allison@securityhealth.org
    www.securityhealth.org
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    19th Annual CEI Virtual Conference


  • 2.  RE: D-SNP Plans & Contact Prior to Eligibility Date

    Posted 09-25-2020 10:09 AM
    I have replied 3 times and I am not sure why it isn't letting me post.
    You have 90 days to contact a lead. I don't know how you are getting you leads but if you have permission to contact then you can contact them and their POA's/Authorized persons, etc. now to set up for AEP. Schedule a time to contact during AEP and get them written into a D-SNP.
    I am sure you are already know that after AEP, they or their POAs, etc. can changed plans during OEP and once each during the first three quarters of the year.

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    [Regina] [Sisk]
    [Compliance Officer]
    [The Equita Group]
    [Dallas][Texas]
    [r.sisk@equita1.com]
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    19th Annual CEI Virtual Conference