Sage Screening Program Elizabeth Lando-King, PhD, RN Nurse Specialist & Regional Coordinator P R O T E C T I N G , M A I N T A I N I N G A N D I M P R O V I N G T H E H E A L T H O F A L L M I N N E S O T A N S
The Sage Program History • First funded by the CDC in 1992 at 2 clinics • MN one of four states to get initial funding • Over 160,000 women screened / Over 2,600 cancers detected Now • Statewide access in 86 counties • Incorporating systems change PROTECTING, MAINTAINING AND IMPROVING THE HEALTH OF ALL MINNESOT ANS
Sage Screening Programs • Paying for cancer screening tests at contracted sites • Systems change work • Helping spread cancer screening & prevention messages • Partnering with communities • Researching how to get more people screened PROTECTING, MAINTAINING AND IMPROVING THE HEALTH OF ALL MINNESOT ANS
Sage Program Goals & Objectives Help keep Minnesotans healthy through screening and early detection of breast & cervical cancers. Help low-income, uninsured, and underinsured women gain access to cancer screening. PROTECTING, MAINTAINING AND IMPROVING THE HEALTH OF ALL MINNESOT ANS
Covered Services • Screening and diagnostic services related to breast & cervical cancer for women ages 40 to 64 • Including: • Screening office visit • Mammogram every year • Pap test every 3 years OR every 5 years with HPV testing • Follow-up office visits and/or diagnostic tests for abnormal results
Eligibility • Women ages 40 – 64 • Uninsured/underinsured • Income ≤ 250% FPL • Eligibility Exceptions
Case Study: Am I eligible? • Patient is 45 years old • Patient has insurance (not Medicaid), but her insurance does not pay for diagnostic testing • Patient owns her own business and makes a different amount every month
When Can a Patient Be Enrolled? • Before Appointment • During Appointment • After Appointment
Clinic Processes 1. Enrollment Form/Visit Summary 2. Imaging Summary 3. Pap Summary 4. Follow-Up Forms
How to Enroll • Consent/Enrollment Form • Please make sure all patients sign & date this form 1 0 / 3 0 / 2 0 1 9
Consent/Enrollment Form • Patients fill out pages 1 – 3 Please remember: • Encounter number • Name/phone number • Eligibility Information
Consent/Enrollment Form: Visit Summary • Provider (or assistant) completes • Clinical breast exam (CBE) not required (recommended) • At least one service must be recorded 1 0 / 3 0 / 2 0 1 9
Consent/Enrollment Form: Visit Summary Pay attention to these questions, especially for certain patients • Does the patient report breast symptoms? • Does the patient report family history of breast cancer
Imaging Summary & Pap Summary
Follow-Up Forms: Abnormal Breast Screening • Will be sent to clinic • Please fill out & return • Questions? → Nikki Kuechenmeister 1 0 / 3 0 / 2 0 1 9
Follow-Up Forms: Abnormal Cervical Screening • Will be sent to clinic • Please fill out & return • Questions? → Nikki Kuechenmeister
Overview of Process at Sage • Paperwork comes in* • Missing info? • Eligibility Issues? • Many other issues- goes to Regional Coordinator • Claims come in • If ALL paperwork is in, claims approved • Follow-up when needed *MUST RECEIVE COMPLETED PAPERWORK & BILLING WITHIN 120 DAYS OF DOS
PROTECTING, MAINTAINING AND IMPROVING THE HEALTH OF ALL MINNESOT ANS 1 0 / 3 0 / 2 0 1 9
1 0 / 3 0 / 2 0 1 9 P R O T E C T I N G , M A I N T A I N I N G A N D I M P R O V I N G T H E H E A L T H O F A L L M I N N E S O T A N S 2 0
&
After Diagnosis: Options Underinsured women with cancer or pre-cancer • Payments towards insurance deductibles • Hospital financial counselors Uninsured women with cancer or pre-cancer • Medical Assistance for Women with Breast or Cervical Cancer (MA/BC)
Medical Assistance for Women with Breast or Cervical Cancer • History (State Statute) • MA/BC Eligibility Determination/Enrollment • MA/BC Temporary Eligibility • Ongoing MA/BC Coverage
MA/BC Eligibility Criteria • MN resident • Sage Screening Program • Need treatment and/or staging services • Under age 65 • Have no creditable insurance • Not otherwise eligible for MA
MA/BC Eligibility Determination/Enrollment • Copy of Sage Enrollment Form • MA/BC Application/Renewal Form (Form DHS-3525) • General Consent for Release of Information (Form DHS- 2243a) • MA/BC County Contact List
Temporary Medical Assistance/Presumptive Eligibility • Provides immediate coverage for a temporary period • May be presumptively granted • Citizenship/immigration status is not a factor in determining presumptive eligibility • For more information including how to apply, please contact your Regional Coordinator
Who Should I Contact With Questions? • Elizabeth Lando-King, Nurse Specialist & Regional Coordinator Elizabeth.Lando-King@state.mn.us, 651-201-5632 • Liz Wilson-Lopp, Regional Coordinator Elizabeth.Wilson-Lopp@state.mn.us, 651-201-5617 • Dai Vu, Community Liaison & Regional Coordinator Dai.Vu@state.mn.us, 651-201-5611 • Nikki Kuechenmeister, Follow-Up Coordinator & Regional Coordinator Nikki.Kuechenmeister@state.mn.us, 651-201-5904
Thank you. Elizabeth Lando-King, PhD, RN Elizabeth.Lando-King@state.mn.us 651-201-5632 WWW.HEALTH.MN.GOV
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