February 2020 Continuing Education Trusted advising resources - - PowerPoint PPT Presentation

▶
february 2020 continuing education
SMART_READER_LITE
LIVE PREVIEW

February 2020 Continuing Education Trusted advising resources - - PowerPoint PPT Presentation

Jun 01, 2023 183 likes •596 views

February 2020 Continuing Education Trusted advising resources Todays agenda 1. Learning objectives 2. Publications 3. Troubleshooting and sharing time 4. SHIBA issues and reference materials 5. SHIBA resources: Volunteer Handbook and

slide-1
SLIDE 1

February 2020 Continuing Education

Trusted advising resources

slide-2
SLIDE 2

Today’s agenda

1. Learning objectives 2. Publications 3. Troubleshooting and sharing time 4. SHIBA issues and reference materials 5. SHIBA resources: Volunteer Handbook and VRPM ( and POM) 6. Scope and confidentiality 7. Secure email protocol 8. Primary trusted resources 9. Medicare & You, Sections 9 and 10

  • 10. CMS training modules
  • 11. Advising clients and helping with complaints
  • 12. 2020 continuing education topics
  • 13. Continuing education evaluation

SHIBA Advisor Continuing Education | February 2020 2

slide-3
SLIDE 3

Learning objectives

After today’s training you should be able to explain:

  • What information is in Medicare & You (M&Y) sections 9

and 10 and how to use the M&Y handbook.

  • How to help a client when they complain about coverage,

billing and other Medicare-related issues.

  • How to use your Volunteer Handbook.
  • The purpose of the VRPM.
  • The purpose of confidentiality and SHIBA’s expectations.
  • SHIBA’s scope.
  • Why we must use SHIBA trusted sources and approved

materials.

SHIBA Advisor Continuing Education | February 2020 3

slide-4
SLIDE 4

Publications

Partner publication: Medicare & You 2020 www.medicare.gov/sites/default/files/2019-09/10050- medicare-and-you_0.pdf Partner publication: Who is KEPRO www.keproqio.com/media/1280/keproflyer_final_508.pdf Partner publication—Login required: CMS Module 01: Understanding Medicare cmsnationaltrainingprogram.cms.gov/?q=global- search&combine=module SHIBA job aid: Advising complaint process and checklist www.insurance.wa.gov/sites/default/files/documents/shiba- complaints-process_0.pdf

SHIBA Advisor Continuing Education | February 2020 4

slide-5
SLIDE 5

Troubleshooting and sharing

  • Review Open Enrollment (if needed)
  • Review January topics
  • What’s new for 2020
  • Counseling tips for veterans
  • Review publications from January training
  • 2020 Part A and Part B covered services
  • Understanding Medicare Advantage & Prescription Drug

Plan Enrollment Periods

  • Get your new Medicare card
  • Veteran health care and Medicare
  • Local topic sharing
  • Other topics

SHIBA Advisor Continuing Education | February 2020 5

slide-6
SLIDE 6

SHIBA issues and reference materials

As a volunteer advisor you’ll deal with many issues that’ll require using trusted-source materials. Today we’ll discuss and review a variety of topics and materials including:

  • Volunteer Handbook (VH)
  • Volunteer Risk and Program Management (VRPM) manual
  • Program Operations Manual (POM)
  • Scope and confidentiality
  • Publications
  • SHIBA client publications
  • SHIBA Jobs aids
  • Partner publications
  • Medicare & You 2020
  • CMS modules
  • Advising clients and helping with complaints

SHIBA Advisor Continuing Education | February 2020 6

Activity: Explain the difference between these three types of publications.

slide-7
SLIDE 7

SHIBA resources: Volunteer handbook

Volunteer Handbook (VH): The purpose is to define what SHIBA does and how volunteers may help. It explains roles, rules and expectations. It helps to answer questions about the roles of volunteers and the processes supporting SHIBA’s mission. Key refresher points:

  • About SHIPs and SHIBA, page 10
  • Supervision and performance management, page 36
  • SHIBA scope, page 41
  • Celebrating volunteers, page 43
  • SHIBA policies and procedures, page 44
  • My SHIBA, page 65
  • Publications and materials, page 66
  • Reporting – STARS, page 67
  • Using state resources, page 68
  • SHIBA News Flash, page 69

Continued

SHIBA Advisor Continuing Education | February 2020 7

slide-8
SLIDE 8

SHIBA resources: VH (continued)

Volunteer Handbook: SHIBA updates the handbook regularly.

  • A few updates on the way include:
  • Roles and responsibilities for volunteers and staff
  • Senior Medicare Patrol (SMP) information

SHIBA Advisor Continuing Education | February 2020 8

slide-9
SLIDE 9

SHIBA resources: VRPM

Volunteer Risk and Program Management (VRPM): The purpose is to enhance the quality, effectiveness and safety of SHIBA and Senior Medicare Patrol (SMP) services by offering guidance and direction to staff and volunteers. SHIBA considers following these policies and practices critical to sustain a strong, dynamic and robust network of volunteers. This information is a reminder that there are many trusted resources for you to use. The VRPM can be found on My SHIBA.

SHIBA Advisor Continuing Education | February 2020 9

slide-10
SLIDE 10

SHIBA resources: POM

Program Operations Manual (POM) The purpose is to provide operational policies and procedures for SHIBA Volunteer Coordinators (VCs), sponsors and OIC staff. Key refresher points

  • A primary document for VCs and sponsors.
  • Topics include directional and support

information for the role of the VC, outreach, contract management, communications, information technology and resources. Updates on the way: This document is under review along with the VH and VRPM to ensure uniform and consistent information between documents. The POM can be found on My SHIBA.

SHIBA Advisor Continuing Education | February 2020 10

slide-11
SLIDE 11

Scope

Volunteers are expected to stay within scope while working for SHIBA. The SHIBA scope is the extent to which you may work as a SHIBA volunteer

  • advisor. SHIBA expects you to stay within the boundaries of the Volunteer

Handbook and VRPM and to provide advice that is unbiased and confidential. When you are unable to provide answers within the SHIBA scope, then you should refer clients to trusted outside sources to help with questions that are within the area of their expertise. Scope: Review the Volunteer Handbook page 41. Continued

SHIBA Advisor Continuing Education | February 2020 11

slide-12
SLIDE 12

Scope (continued)

Expectations

  • Provide the same level of service
  • Know when to ask for help
  • Use authoritative and SHIBA approved materials

Activity: Discuss some authoritative Medicare sources and why it’s important to work with these sources. Activity: Discuss publications that are from authoritative sources. Are there any you would like to see that we have not yet developed? Continued

SHIBA Advisor Continuing Education | February 2020 12

slide-13
SLIDE 13

Scope (continued)

Types of duties within a volunteer’s scope

  • Screen clients’ eligibility for various health care coverage
  • ptions including Medicare, Medigap, private health

insurance, low-income programs and COBRA (Consolidated Omnibus Budget Reconciliation Act).

  • Provide clients and community members with unbiased

information about Medicare and health insurance options.

  • Advise clients about points to think about with regard to

their Medicare and health insurance options.

  • Educate the community about Medicare fraud identification

and prevention. Continued

SHIBA Advisor Continuing Education | February 2020 13

slide-14
SLIDE 14

Scope (continued)

Types of duties within a volunteer’s scope

  • Counsel and/or enroll clients in Medicare programs and

plans when eligible and appropriate.

  • Assist low-income clients research prescription and

co-insurance options.

  • Let clients know they can call the OIC’s statewide toll-free

Insurance Consumer Hotline at 1-800-562-6900 and get more information at www.insurance.wa.gov. Activity: Discuss issues you have encountered in your SHIBA work that have caused you to stop and consider whether you’re working in or out of scope.

SHIBA Advisor Continuing Education | February 2020 14

slide-15
SLIDE 15

Confidentiality

SHIBA volunteers are responsible for protecting private information

  • btained while volunteering. You cannot disclose to unauthorized

people any confidential information you acquire through official

  • duties. You also cannot use such information for personal gain or

benefit, or for the gain or benefit of others. SHIBA carefully protects the confidentiality of information collected during volunteer screening. It may be shared with SHIBA staff as needed in deciding volunteer suitability. (VRPM Policy 3.43) Feel free to ask for help before you release any personal

  • information. It’s always better to ask for help beforehand than to

make a mistake. (VH page 47)

SHIBA Advisor Continuing Education | February 2020 15

slide-16
SLIDE 16

Secure email protocol

As of Jan. 1, 2020, the Office of the Insurance Commissioner and SHIBA have new protocols for email security:

  • External recipients of OIC/SHIBA secured email will be prompted to register for

the new service; in other words, their old account (user name and password) will no longer work.

  • Recipients of secure emails will receive instructions for registration to the new

service upon first use. We expect this process to be as straightforward as with any online registration process.

  • In the meantime, if you have any questions regarding the encrypted email

service change, please contact the Support Center at 360.586.1000 / 1.855.WaTech1 (1.855.928.3241) or support@watech.wa.gov.

SHIBA Advisor Continuing Education | February 2020 16

slide-17
SLIDE 17

Primary trusted sources

SHIBA Advisor Continuing Education | February 2020 17

You have many authoritative resources available to you as a SHIBA volunteer including:

  • Medicare & You
  • medicare.gov
  • My SHIBA login required
  • ic.wa.gov
  • cms.gov
  • shiptacenter.org
  • ssa.gov
  • Medicare saving program
  • Washington healthplanfinder
  • SHIBA staff, including your

Volunteer Coordinator (VC) and Regional Training Consultant (RTC)

  • SHIBA Volunteer Handbook
  • Volunteer Risk and Program

Management Handbook (VRPM)

  • SHIBA Program Operations

Manual

  • PEBB
  • WA Apple Health (Medicaid)
  • Managed Care
  • smpresource.org
  • acl.gov
slide-18
SLIDE 18

Using Medicare & You 2020 as reference

SHIBA’s 2020 volunteer continuing education training will focus on Medicare & You along with supplemental and essential training. Be sure to bring your copy of the handbook with you to training.

SHIBA Advisor Continuing Education | February 2020 18

We’ll:

  • Review information in the

section planned for that month.

  • Share related job aids and

consumer publications.

slide-19
SLIDE 19

Medicare & You: Section 9

Section 9: Get more Information

  • Where can I get personalized help: 1-800-Medicare
  • 24/7
  • TTY users 1-877-486-2048
  • Information for someone calling on your behalf
  • To stop receiving paper copies of M&Y
  • What are SHIPs?

Continued

SHIBA Advisor Continuing Education | February 2020 19

slide-20
SLIDE 20

Medicare & You: Section 9 (continued)

Section 9: Get more information

  • Do you need someone to call 1-800-MEDICARE on

your behalf?

  • This form is used to advise Medicare of the person or

persons you have chosen to have access to your personal health information.

  • CMS Form 10106 (Rev. 03/19)

www.cms.gov/Medicare/CMS-Forms/CMS- Forms/Downloads/CMS10106.pdf

  • See next slide to see the first page of the form.

Continued

SHIBA Advisor Continuing Education | February 2020 20

slide-21
SLIDE 21

Medicare & You: Section 9 (continued)

Continued

SHIBA Advisor Continuing Education | February 2020 21

To view this form and instructions, visit: www.cms.gov/Medicare/CMS- Forms/CMS- Forms/Downloads/CMS10106.pdf It hasn’t been included in your training packet.

slide-22
SLIDE 22

Medicare & You: Section 9 (continued)

Section 9: Get more information

  • Where can I find general Medicare information
  • nline?
  • Visit Medicare.gov
  • Covers information about type of assistance provided
  • n the website including preventative services

information, helpful websites and phone numbers. Continued

SHIBA Advisor Continuing Education | February 2020 22

slide-23
SLIDE 23

Medicare & You: Section 9 (continued)

Section 9: Get more Information

  • Where can I find personalized Medicare information
  • nline?
  • Register at MyMedicare.gov
  • Covers what to do if a client is still waiting for their

new Medicare card and MyMedicare.gov’s Blue Button. Continued

SHIBA Advisor Continuing Education | February 2020 23

slide-24
SLIDE 24

Medicare & You: Section 9 (continued)

Section 9: Get more Information

  • How do I compare the quality of health care

providers

  • Medicare.gov/quality-care-finder
  • Covers the importance of talking to your health care

provider and asking your doctor or other health care provides what they think about the quality of care

  • ther providers give.

Continued

SHIBA Advisor Continuing Education | February 2020 24

slide-25
SLIDE 25

Medicare & You: Section 9 (continued)

Section 9: Get more Information

  • How do I compare the quality of Medicare health

and drug plans

  • Medicare.gov/plan-compare
  • Covers the star rating system for the quality of many

medical/health care services and also the quality of prescription-related services. Continued

SHIBA Advisor Continuing Education | February 2020 25

slide-26
SLIDE 26

Medicare & You: Section 9 (continued)

Section 9: Get more information

  • What’s Medicare doing to better coordinate my care?
  • Covers Electronic Health Records, electronic

prescribing, and Accountable Care Organizations Continued

SHIBA Advisor Continuing Education | February 2020 26

slide-27
SLIDE 27

Medicare & You: Section 9 (continued)

Section 9: Get more information

  • Are there other ways to get Medicare information?
  • Covers publications, social media, video and blogs

Continued

SHIBA Advisor Continuing Education | February 2020 27

slide-28
SLIDE 28

Medicare & You: Section 9 (continued)

Section 9: Get more information

  • Other helpful contacts
  • Covers contact information for Social Security,

Benefits Coordination & Recovery Center, KEPRO*, Department of Defense, Department

  • f Veterans Affairs, Office of Personnel

Management and the Railroad Retirement Board. Continued

*See more information on the next slide

SHIBA Advisor Continuing Education | February 2020 28

slide-29
SLIDE 29

Medicare & You: Section 9 (continued)

KEPRO is the new LIVANTA. It is the Beneficiary and Family Centered Care QIO (BFCC-QIO) for 29 states. They offer information regarding beneficiary complaints, hospital discharge and skilled service termination appeals as well as Immediate Advocacy. www.keproqio.com WA state phone number: 1-888-305-6759 Continued

SHIBA Advisor Continuing Education | February 2020 29

The Quality Improvement Organization (QIO) Program is the cornerstone of Medicare’s efforts to improve the quality of care and health outcomes for beneficiaries.

slide-30
SLIDE 30

Medicare & You: Section 9 (continued)

KEPRO Information flyer www.keproqio.com/media/1280 /keproflyer_final_508.pdf See the full size handout in your training packet. Continued

SHIBA Advisor Continuing Education | February 2020 30

slide-31
SLIDE 31

Medicare & You: Section 9 (continued)

Section 9: Get more information

  • State Health Insurance Assistance Programs (SHIPs)
  • Covers contact information for each state and

territory.

  • SHIBA 800-562-6900

SHIBA Advisor Continuing Education | February 2020 31

slide-32
SLIDE 32

Knowledge check: M&Y Section 9

Q1: What does a client need to do if they would like someone to call Medicare on their behalf—now

  • r down the road?

Q2: How could a client find the contact information for their local SHIP if they are moving to another state? Q3: What should a client do if they are still waiting for their new Medicare card? Q4: Name at least three other ways than Medicare.gov to get Medicare information.

SHIBA Advisor Continuing Education | February 2020 32

slide-33
SLIDE 33

Medicare & You: Section 10

Section 10: Definitions for 25 Medicare terms. Activity: Define the following terms. Share some experiences

  • f advising sessions that focused on these terms.
  • Assignment
  • Custodial care
  • Formulary
  • Medicare-approved amount
  • Preventive services
  • Skilled nursing facility (SNF care)

Continued

SHIBA Advisor Continuing Education | February 2020 33

slide-34
SLIDE 34

Medicare & You: Section 10 (continued)

Optional discussion questions Section 10 covers definitions. How useful is this part of the booklet in your advising work? Which terms can be most difficult for your clients to understand?

SHIBA Advisor Continuing Education | February 2020 34

slide-35
SLIDE 35

Medicare & You: Activity options

  • Activity: Name sources that can be referred to for Medicare
  • terms. For instance, what is an authoritative source for Extra

Help or for Long-term Care?

  • Have a conversation about the term “medically necessary” p.

114.

  • Activity: Discuss other terms that could be included in the

section 10 list and are not.

SHIBA Advisor Continuing Education | February 2020 35

slide-36
SLIDE 36

CMS training modules

SHIBA Advisor Continuing Education | February 2020 36

The Centers for Medicare and Medicaid Services (CMS) training modules are part of the CMS National Training Program (NTP) and are a trusted resource for reference and study. You’ll find these modules in the CMS NTP resources at cmsnationaltrainingprogram.cms.gov/?q=global- search&combine=module. We’ll cover sections of these modules during some of the SHIBA continuing education training sessions.

slide-37
SLIDE 37

Advising clients and helping with complaints

Review the SHIBA job aid Advising complaint process and checklist. It’s located in your packet and on My SHIBA. www.insurance.wa.gov/sites/default/files/documents/shiba- complaints-process_0.pdf Do you know:

  • How to escalate a call?
  • How to help a client when you’re not sure what to do?
  • What to do about complaints?
  • How to help a client get the OIC complaint form and fill it out?

Remember, don’t immediately say to call SHIBA.

  • What do you do if you don’t know what to do?

If you’re not sure what to do, ask your Volunteer Coordinator or RTC.

SHIBA Advisor Continuing Education | February 2020 37

slide-38
SLIDE 38

Knowledge check: Publications & advising

Q1: Which partner publication could you refer to if a client has a questions about an appeal process? Q2: What is your next step if you are unable to assist a client after working through the checklist on the job aid Advising and complaint process checklist?

SHIBA Advisor Continuing Education | February 2020 38

slide-39
SLIDE 39

2020 continuing education topics

SHIBA Advisor Continuing Education | February 2020

Month Topic Medicare & You March Signing up for Medicare and learning what Medicare covers Sections 1 and 2 April Volunteer recognition and updated help paying for Medicare Section 7 May Know your rights and protecting yourself from fraud Section 8 June Disabilities and transitioning from Medicaid to Medicare July Original Medicare and Medicare Supplements Sections 3 and 5 August No training September Getting ready for Open Enrollment and comparing health and prescription drug plans in your area Section 4 October Medicare Part D and Medicare Advantage Section 6 November No training December No training

39

slide-40
SLIDE 40

Evaluation

We appreciate your feedback!

SHIBA Advisor Continuing Education | February 2020 40