CAPWN HEALTH CENTER PATIENT HANDBOOK

Transcription

1 CAPWN HEALTH CENTER PATIENT HANDBOOK Crescent Drive, Gering Nebraska (308)

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3 Cmmunity Actin Partnership f Western Nebraska (CAPWN) Health Center has been awarded Recgnitin by the Natinal Cmmittee fr Quality Assurance (NCQA) Patient Centered Medical Hme (PCMH ) 2011 Recgnitin Prgram. NCQA is an independent, nn-prfit rganizatin dedicated t imprving health care quality. The NCQA PCMH 2011 standards emphasize the use f systematic, patient-centered, crdinated care that supprts access, cmmunicatin and patient invlvement. The patient-centered medical hme prmises t imprve health and health care, said NCQA President Margaret E. O Kane. The active, nging relatinship between a patient and a physician in medical hmes fsters an all-t-rare gal in care: staying healthy and preventing illness in the first place. PCMH Recgnitin shws that CAPWN Health Center has tls, systems and resurces t prvide their patients with the right care at the right time. Patient-Centered Medical Hme (PCMH ) is a trademark f the Natinal Cmmittee fr Quality Assurance

4 Welcme t Cmmunity Actin Partnership f Western Nebraska (CAPWN) Health Center. We want t thank yu fr chsing CAPWN Health Center as yur medical hme. Gd health care requires a gd relatinship between the patient and their prvider. Part f building that gd relatinship is making sure that the patient and the prvider are cmmunicating well with each ther. Yu can help keep that cmmunicatin gd by letting the prvider r staff knw if yu d nt understand smething r if yu are in need f smething. Yu can als help keep that cmmunicatin gd by prviding ur staff with the infrmatin they ask f yu. In turn we will d ur best t prvide yu with the services and infrmatin yu need t imprve yur health care. This bklet will prvide yu with infrmatin abut what we can ffer yu as a patient at CAPWN Health Center. In turn it will give yu infrmatin n hw yu can help make yur experience here a gd ne. We lk frward t being yur medical hme and being a partner in yur healthcare. Sincerely, Jeff Tracy Directr, CAPWN Health Center

5 Wh We Are CAPWN Health Center is Yur Medical Hme Patient Rights & Respnsibilities Clinic Hurs & Lcatin Services Appintments Family Medical Health Care Dental Care Mental Health Cunseling Reprductive Health Prgram (RHP) Wmen, Infant, & Children (WIC) Immunizatins Migrant Health Minrity Health HIV/Hepatitis C Testing & Cunseling Diabetes Educatin & Care X-ray & Lab On-Site Nutritinal Cunseling Transprtatin & Interpretatin Services Making an Appintment What t Bring t Yur Appintment Cancelling an Appintment When the Health Center is Clsed Paying fr Services Insurance Infrmatin Sliding Fee Scale Questins Abut Yur Bill Prtecting Yur Health Recrds Filing a Cmplaint Phne Directry Resurces Des Smene Yu Knw Need a Medical Hme?

6 Intrductin Cmmunity Actin Partnership f Western Nebraska (CAPWN) is a nn-prfit cmmunity based rganizatin. CAPWN Health Center became a part f CAPWN in 1992 and is a Federally Qualified Health Center (FQHC). CAPWN Health Center is ne f seven FQHC s in Nebraska and like all FQHC s prvides medical care, dental care and mental health care t its patients. As a FQHC, CAPWN Health Center receives sme federal funding frm the Bureau f Primary Health Care and sme funding frm the state f Nebraska but the largest single percentage f funding fr its peratins cmes frm what patients pay fr their medical care. CAPWN Health Center is dedicated t meeting the health care needs f the cmmunity and supprts the Patient Centered Medical Hme mdel f care. Our Missin The missin f CAPWN Health Center is t prvide all patients and their families access t individualized, crdinated, quality health care and educatin; thereby empwering peple with the knwledge and services t make healthy life-style chices leading t acceptance f respnsibility fr persnal wellness Our Values Respect-Cncern-Cperatin-Care Bard f Directrs CAPWN Health Center is gverned by a cmmunity bard made up f a representatin f the ppulatins that we serve. The Bard is cmprised f individuals wh vlunteer their time and energy t create a fiscally and managerially strng rganizatin fr the purpse f imprving the health status f ur cmmunities

7 CAPWN Health Center fllws the Patient Centered Medical Hme Mdel. Medical hmes are a new way f thinking abut yu and yur families health care. A Medical Hme team is YOU and yur chsen prvider team wrking tgether t rganize the care that is best fr yu. Yur health care team may include dctrs, physician assistants, nurses, specialists, dentists, therapists and care crdinatrs. Cnsistently sharing infrmatin between yu and yur prvider team will ensure quality care and help t reduce visits t the emergency rm and hspital admissins. All f ur patients will receive evidence-based care and selfmanagement supprt fr all f the care they receive by us, their Medical Hme. CAPWN Health Center accepts ALL patients, including: Uninsured Medicaid (Nebraska & Wyming) Medicare Private Insurance And accepts ALL age grups: Infants and Children Teens Adults Senir Citizens

8 OFFICE HOURS Medical Clinic: Mnday-Thursday 8:00 a.m.-6:30 p.m. & Friday 8:00 a.m.-5:00 pm Dental Clinic: Mnday-Friday 7:00 a.m.-5:00 pm CONTACT INFORMATION Medical Clinic Dental Clinic (308) (308) WIC Reprductive Health Prgram (308) (308) AFTER-HOURS (308)

9 CAPWN Health Center respects each patient and is dedicated t giving the best care pssible. Patient Rights and Respnsibilities explain what yu can expect frm us and, in turn, what we expect f yu. Yu have the right t: 1. Receive respectful and safe care by cmpetent persnnel; 2. Receive quality care withut discriminatin based upn race, clr, religin, gender, natinal rigin, r payer; 3. Receive care in a clean, secure, and safe place 4. Be infrmed f patient rights during the admissin prcess; 5. Be infrmed in advance abut care and treatment and related risks; 6. Invlve family members in making decisins abut yur care; 7. Make infrmed decisins regarding care and treatment and t receive infrmatin necessary t make thse decisins; 8. Refuse a treatment r any part f a treatment, and be infrmed f the medical cnsequences f refusing such care; 9. Evaluate and manage yur pain, including a referral t a pain specialist; (Only nn-narctic shts fr pain are available in this clinic!) 10. Receive care in a manner that hnrs and respects yur persnal and religius beliefs and cultural values; 11. Ask fr a secnd medical pinin; 12. Ask t see a medical specialist; 13. Help t chse yur Dctr and knw abut their training; 14. Knw the rules n hw yu are t behave while yu are in the clinic; 15. Have an interpreter r ther assistance in cmmunicatin; 16. Turn in a cmplaint abut the clinic and receive a respnse; 17. Frmulate advance directives and have the health clinic cmply with the directives unless the clinic ntifies the patient f the inability t d s; 18. Dnate rgans and tissue; 19. Maintain the privacy and cnfidentiality f yur health care infrmatin and recrds; 20. Access infrmatin cntained in yur medical recrd within a reasnable time when requested; 21. Be free frm abuse, neglect, and explitatin; and 22. Vice cmplaints and grievances withut discriminatin r reprisal and have thse cmplaints and grievances addressed.

10 Yu are respnsible fr: 1. Taking care f yur health; 2. Calling 24 hurs in advance if yu are unable t keep yur appintment; 3. Fllw instructins given by yur healthcare prvider fr yurself, yur children, r thers fr whm yu care; 4. Getting annual checkups fr yu and yur family; 5. Getting yur medicatins befre yu run ut; 6. Letting CAPWN staff knw f any prblems that yu r yur family are having; 7. Letting CAPWN staff knw if yu chse t mve yur medical r dental care; 8. Paying yur c-payment at each visit and making an effrt t pay yur bill n time; 9. Giving CAPWN crrect infrmatin; 10. Knwing yur insurance plan; 11. Prviding incme dcumentatin if yu wish t be cnsidered fr a sliding fee discunt. 12. Shwing respect fr ther patients and CAPWN staff; 13. Calling abut n-ging r nn-emergency health prblems during ffice hurs; 14. Telling yur prvider abut yur pain; 15. Asking yur prvider if yu d nt understand any infrmatin r instructins given t yu.

11 Quality Care Every member f ur cmmunity deserves t receive quality healthcare services frm qualified prfessinals. All f ur prviders are bard certified with many years f experience in ur cmmunity. CAPWN Health Center als cntracts with prviders in specialty health care areas such as fr ENT services and HIV care. Cmprehensive Care Our facility ffers quality health care services t all members f the family, including specialized care in geriatrics and pediatrics. We are able t prvide fr a full range f healthcare needs including: Regular Family Practice care Schl & sprts physicals CDL/DOT physicals Immigratin physicals Well-child check ups Prenatal care Vaccinatins STD Testing & Cunseling Interpretatin & Translatin (fr Spanish) Limited transprtatin services Labratry The majrity f all lab tests rdered by yur prvider are perfrmed by ur internal labratry staff and are prcessed n-site t ensure timely testing and results.

12 Radilgy Radilgy services are ffered n-site t perfrm diagnstic x-rays f the extremities, chest, bne injuries, and ther bdy images fr healthcare maintenance. Case Management Services Case management services are available t assist yu with meeting gals fr yur health and fr the management f chrnic illnesses and preventive maintenance health care needs. HIV/Hepatitis C Care CAPWN Health Center ffers cmprehensive testing and cunseling services fr the treatment f HIV and Hepatitis C as well as prviding licensed staff t assist with individualized case management services. Behaviral Health Services CAPWN Health Center has ne licensed mental health prvider n staff t prvide behaviral health services as an integrated cmpnent f primary health care. These services may be used by any CAPWN Health Center patient with a referral frm their primary care prvider within the health center. Reprductive Health Prgram CAPWN Health Center s Reprductive Health Prgram (RHP) emplys caring and prfessinal staff ffering cnfidential educatin, testing, and cunseling fr all facets f reprductive and preventative health care service needs.

13 Wmen, Infants & Children (WIC) Nutritin Prgram CAPWN s WIC Prgram safeguards the health f lw-incme wmen, infants and children up t age five wh are at a nutritin risk by prviding nutritius fds t supplement diets, infrmatin n healthy eating, and referrals t health care. Immunizatin Prgram CAPWN Health Center ffers immunizatins fr infants t adults. Children up t the age f 18 n Medicaid, nninsured r underinsured can receive vaccinatins free f charge thrugh the Vaccinatins fr Children Prgram. Immunizatins can be administered t VFC, private insurance patients and adults f all ages during their regular medical visits and during schl physicals. Minrity Health Prgram CAPWN Health Center s Minrity Health Prgram ffers several services t patients including transprtatin, interpretatin, translatin, wellness prgrams, living well classes, and screenings t help patient s access health care services. Migrant Health Prgram This prgram prvides health care fr migrant and seasnal farmwrkers in 19 western Nebraska cunties. The tw primary service centers include the main campus at CAPWN Health Center and a seasnal ff-site lcatin in Alliance Nebraska.

14 Transprtatin, Interpretatin, & Translatin Services CAPWN Health Center ffers free limited transprtatin services t patients t ensure we re meeting the needs f ur members. We als have bilingual staff emplyed t help with the written and verbal cmmunicatin needs f ur Spanish speaking patients. Diabetes Educatin & Care and Nutritinal Cunseling CAPWN Health Center has a registered nurse n staff t assist patients with their diabetes educatinal and care needs. Diabetes classes, screenings, and infrmatin are cnveniently prvided t patients during their regular medical visits and during afternn r evening times. Patients can als receive tips n establishing a healthy diet and exercise prgram thrugh the use f ur n-site nutritinist. 340B Medicatin Assistance Prgram If yu have applied fr a sliding fee discunt yu can take advantage f a discunt at Gering U-Save Pharmacy fr yur prescriptins. The prescriptin C-Pays are as fllws: *Yu will pay the cst f yur medicatin plus yur C-Pay. A Scale $9.00 B Scale $12.00 C Scale $12.00 D Scale $12.00 E Scale $12.00 F Scale $15.00 Must be an established patient at CAPWN Health Center; Must be either uninsured, n Medicare, have private insurance (Medicaid patients are nt able t participate in this prgram); Have a prescriptin frm a CAPWN Health Center prvider; Get yur prescriptin filled at the Gering U-Save Pharmacy in Gering.

15 Dental Care CAPWN Health Center Dental Clinic ffers services fr all ages. We are able t prvide fr a variety f dental needs, including: Rutine dental care (cleanings, x-ray, & examinatin) Fillings Extractins Emergency treatment (fr pain, swelling, brken teeth, etc.) Limited rt canal therapy Prenatal dental care Pediatric dental care Emergency dental care is available Mnday thrugh Friday, with drs pening at 7:00am. Emergency care is n a first cme first serve basis.

16 T Make a Medical Appintment Call us at (308) r tll free T Make a Dental Appintment Call us at (308) r tll free What t Bring n Yur First Visit Fr yur first visit at CAPWN Health Center, yu will be asked t cmplete new patient frms. These frms becme a part f yur medical chart which includes demgraphic infrmatin such as yur address, phne number, emplyment and insurance carriers. Other new patient frms will include a basic questinnaire f yur persnal and family health histry. T qualify fr ur sliding fee prgram, uninsured r privately insured patients are als asked t bring in prf f their husehld incme. A financial cunselr will assist with this prcess.

17 Cancelling an Appintment CAPWN Health Center understands that smetimes yu are nt able t keep yur appintment. Yu are respnsible fr ntifying the health center t cancel an appintment in advance f yur appintment time. Appintment Reminder Call CAPWN Health Center makes every effrt t prvide an appintment reminder call t help ur patients remember their appintments. The call ccurs 1 t 2 business days prir t the appintment date. When yu receive a reminder call, yu may cnfirm yur appintment r request that it be rescheduled. When the Health Center is Clsed CAPWN Health Center prvides cverage 24 hurs a day, seven days a week t ensure cntinuity f care. An Answering Service Prvider will be utilized and activated each day at the clse f the business day. It is the expectatin that the n-call prvider will return the patient s phne call in less than ne hur f receiving the message frm the Answering Service Prvider. All patient phne calls and utcmes, including any clinical advice given, will be dcumented in the patient s electrnic health recrd within 72 hurs f ending the call.

18 Insurance As a curtesy, CAPWN Health Center will gladly submit yur claim t any private insurance cmpany and Medicare, alng with Medicaid frm Nebraska r Wyming fr yu. The patient s insurance card must be submitted at the time f service. CAPWN Health Center is a participating prvider with all majr insurance carriers. If yu have questins abut yur health plan, please call ur billing department at (308) Sliding Fee Discunt Prgram Plicy The sliding fee prgram allws us t reduce r slide the fees fr the care f yu r yur family at CAPWN Health Center. Yu can apply fr the prgram if yu need assistance t help yu pay fr yur care.. If yu dn t wish t be cnsidered fr the sliding fee, a Decisin t Pay Full Fee frm is prvided fr yur signature. Hw t Apply fr a Sliding Fee Discunt Once yu becme a patient at CAPWN Health Center, a financial cunselr will be available t meet with yu at yur first visit t help yu apply fr the prgram. Yu will need t prvide prf f incme dcumentatin t be eligible t apply fr the sliding fee discunt. This will be reviewed at annually.

19 What is cnsidered as Prf f Incme? Current tax return frm This is the mst preferred frm. The tax return will als declare the number f dependents. If the tax return is nt available then ne f the fllwing may be accepted: Pay check stubs frm all members f the husehld. Check stubs must be dated within the last mnth; Any frm f paperwrk frm the Nebraska Department f Health and Human Services that deals with Aid t Dependent Children r Fd Stamps. WIC paperwrk may als be acceptable. The paperwrk has t shw mnthly benefit amunt received. If the State has already verified the incme f the patient, this is acceptable verificatin; Any paperwrk frm Unemplyment t prve emplyment status and amunt f unemplyment cmpensatin; A letter frm the emplyer, n cmpany letterhead, stating the average hurs a mnth wrked and amunt paid fr wrk. A cntact persn and a phne number fr the cntact is als expected. This frm f prf must always be verified. Any letter nt n cmpany letterhead is unacceptable; Any letter r paperwrk frm a curt shwing child supprt r alimny payment amunts received. Any ther type f incme prvided will be at the discretin f the Billing Office Manager.

20 Hw much d yu we? The amunt yu we depends n yur family size and incme. There is minimum C-Pay due at the time f service. If any additinal services are rdered by yur prvider during yur visit yu will be billed a percentage f these services based n yur sliding fee discunt. As a Federally Qualified Health Center we will nt refuse services because f a patient s inability t pay.. If patients bring n payment fr nn-emergent visits, the patient will be reschedule until the patient is able t pay the minimum ffice visit based n their sliding fee discunt. In the belw situatins patients will be billed after the fact fr the service prvided. Pediatric visits (18 and under); OB patient visits; Adult acute visit when the medical prvider, after triaging the patient, feels it is a medical necessity that the patient be seen. Sliding Scale Example Husehld Size f 4 with an Annual Incme f $, the patient is respnsible fr: A Scale $ $23,850 = $20 C-Pay and 0% f additinal services B Scale $23,851 - $29,813 = $30 C-Pay and 20% f additinal services C Scale $29,814 - $35,775 = $40 C-Pay and 40% f additinal services D Scale $35,776 - $41,738 = $50 C-Pay and 60% f additinal services E Scale $41,739 - $47,699 = $60 C-Pay and 80% f additinal services F Scale $47,700 r Abve = $90 C-Pay and 100% f additinal services. *Additinal Services include but is nt limited t: Lab, X-ray, Injectables, and Durable Medical Equipment. *Mnthly incme guidelines change every year the abve example is based n 2014 Federal Pverty Guidelines.

21 Frequently Asked Questins abut Sliding Fee Scale Is CAPWN Health Center a free clinic? N. All patients are respnsible fr a prtin f a cst f their care. Wh pays fr the services that are discunted? Grants and dnatins are received t help ffset discunts fr yur care. D I have t be a U.S. Citizen t apply fr the sliding fee discunt? N, we d nt verify citizenship status. What if I DO NOT have any incme at all? Yu can still apply fr the sliding fee discunt. Our financial cunselrs will be able t assist yu. I have t pay a lt f mney befre my insurance pays fr my healthcare. Can I apply fr the sliding fee prgram? Yes, we will bill yur insurance first and then apply yur sliding fee discunt n yur charges after yur insurance prcesses yur claim. Is my incme infrmatin cnfidential? Yes, all infrmatin cllected frm yu is cnfidential because we abide by HIPAA guidelines. Hw ften is eligibility determined fr the sliding fee discunt? Discunt duratin can range frm ne day t ne year. Our financial cunselrs will prvide yu with a cpy f yur individual agreement. Questins Abut Yur Bill Questins abut yur bill shuld be directed t ur Billing Department at (308) Patient Accunt Representatives are available frm 8:00 a.m. t 5:00 p.m. Mnday thrugh Friday.

22 Yur Prtected Health Infrmatin The Health Infrmatin Prtability and Accuntability Act (HIPAA) was implemented natinally in CAPWN is a HIPAA cmplaint entity and understands that infrmatin abut yu and yur health care is persnal. We are cmmitted t prtecting yur infrmatin abut yu fllwing by fllwing HIPAA regulatins. When yu receive services frm us, we create a recrd f the services that yu received. We need this recrd t prvide yu with quality care and t cmply with legal requirements. This ntice applies t all f ur recrds abut yur care, whether made by ur health care prfessinals r thers wrking in ur agency. The first time yu cme t CAPWN fr services we ffer yu a cpy f ur Ntice f Privacy Practices. This dcument is als available t yu at any time upn request. CAPWN s Ntice f Privacy Practices explains what we are required t d by law with yur Prtected Health Infrmatin and the rights yu have as a client f CAPWN. Fr mre infrmatin n HIPAA please review the Ntice f Privacy Practices prvided t yu. If yu have additinal questins r cncerns please ask t speak with the HIPAA Privacy Cntact Persn at the Health Center r the Agency HIPAA Privacy Officer, lcated in the Agency Administratin Building.

23 Filing a HIPAA Privacy Cmplaint If yu believe yur privacy rights have been vilated, yu may file a cmplaint with us r with the Secretary f the Department f Health and Human Services. Yu may file a cmplaint by mailing, faxing r ing us a written descriptin f yur cmplaint r by telling us abut yur cmplaint in persn r ver the telephne: Marg Hartman, Privacy Officer Cmmunity Actin Partnership f Western Nebraska th Street, Gering, NE Please describe what happened, the dates and names f anyne invlved, and hw t cntact yu s that we can respnd t yur cmplaint. Yu will nt be penalized fr filing a cmplaint. Filing a General Cmplaint At CAPWN Health Center want yu t have a pleasant and infrmative visit t ur clinic. If yu have cncerns abut patient care and/r safety within CAPWN, yu are encuraged t cntact CAPWN s Custmer Service Manager r Clinic Directr in persn r by telephne at

24 Phne Directry Medical.. (308) Dental. (308) Reprductive Health Prgram (RHP) (308) Wmen, Infants, & Children (WIC) (308) Minrity Health Prgram.(308) Migrant Health Prgram Gering Clinic...(308) Alliance Clinic (June-Sept)..(308) Diabetes Prgram/Nutritin Cunseling (308) Billing Department (308) HIV/Hepatitis C Prgram..(308) Immunizatin Prgram..(308) AFTER HOURS (after 5pm and Weekends).. (308) Emergency.. Dial 911

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26 Des Smene Yu Knw Need A Medical Hme? We hpe yu will refer yur friends and family t ur clinic. Please detach and share ne f the referral cards with them. D yu need quality health care at an affrdable price? CAPWN Health Center is a nn-prfit primary health care center fr the entire family children, teens, adults, and senir citizens. CAPWN Health Center accepts all patients, insured r uninsured, r n Medicaid, Medicare, Kids Cnnectin, r private insurance. Price f services is based n yur incme. We can explain hw t prvide yur prf f incme. Our Services: Medical Dental Behaviral Health In-Huse Lab & X-rays Immunizatins Reprductive Health Wmen Infant and Children (WIC) Prenatal Care HIV/Hepatitis C D yu need quality health care at an affrdable price? CAPWN Health Center is a nn-prfit primary health care center fr the entire family children, teens, adults, and senir citizens. CAPWN Health Center accepts all patients, insured r uninsured, r n Medicaid, Medicare, Kids Cnnectin, r private insurance. Price f services is based n yur incme. We can explain hw t prvide yur prf f incme. Our Services: Medical Dental Behaviral Health In-Huse Lab & X-rays Immunizatins Reprductive Health Wmen Infant and Children (WIC) Prenatal Care HIV/Hepatitis C

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