Sage Screening Program Elizabeth Lando-King, PhD, RN Nurse - - PowerPoint PPT Presentation

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

Elizabeth Lando-King, PhD, RN Nurse Specialist & Regional Coordinator

Sage Screening Program

PROTECTING, MAINTAINING AND IMPROVING THE HEALTH OF ALL MINNESOT ANS

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

The Sage Program

PROTECTING, MAINTAINING AND IMPROVING THE HEALTH OF ALL MINNESOT ANS

• 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

Sage Screening Programs

PROTECTING, MAINTAINING AND IMPROVING THE HEALTH OF ALL MINNESOT ANS

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.

Sage Program Goals & Objectives

• 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

Covered Services

• Women ages 40 – 64
• Uninsured/underinsured
• Income ≤ 250% FPL
• Eligibility Exceptions

Eligibility

• 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

Case Study: Am I eligible?

• Before Appointment
• During Appointment
• After Appointment

When Can a Patient Be Enrolled?

• 1. Enrollment Form/Visit Summary
• 2. Imaging Summary
• 3. Pap Summary
• 4. Follow-Up Forms

Clinic Processes

1 0 / 3 0 / 2 0 1 9

How to Enroll

• Consent/Enrollment Form
• Please make sure all

patients sign & date this form

Consent/Enrollment Form

• Patients fill out pages 1 – 3

Please remember:

• Encounter number
• Name/phone number
• Eligibility Information

1 0 / 3 0 / 2 0 1 9

Consent/Enrollment Form: Visit Summary

• Provider (or assistant)

completes

• Clinical breast exam

(CBE) not required (recommended)

• At least one service must

be recorded

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

1 0 / 3 0 / 2 0 1 9

Follow-Up Forms: Abnormal Breast Screening

• Will be sent to clinic
• Please fill out & return
• Questions?

→ Nikki Kuechenmeister

Follow-Up Forms: Abnormal Cervical Screening

• Will be sent to clinic
• Please fill out & return
• Questions?

→ Nikki Kuechenmeister

*MUST RECEIVE COMPLETED PAPERWORK & BILLING WITHIN 120 DAYS OF DOS

• 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

Overview of Process at Sage

PROTECTING, MAINTAINING AND IMPROVING THE HEALTH OF ALL MINNESOT ANS 1 0 / 3 0 / 2 0 1 9

2 0 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

&

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)

After Diagnosis: Options

• History (State Statute)
• MA/BC Eligibility Determination/Enrollment
• MA/BC Temporary Eligibility
• Ongoing MA/BC Coverage

Medical Assistance for Women with Breast or Cervical Cancer

• 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 Criteria

MA/BC Eligibility Determination/Enrollment

• Copy of Sage Enrollment

Form

• MA/BC

Application/Renewal Form (Form DHS-3525)

• General Consent for Release
• f Information (Form DHS-

2243a)

• MA/BC County Contact List

• 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

Temporary Medical Assistance/Presumptive Eligibility

• 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

Who Should I Contact With Questions?

WWW.HEALTH.MN.GOV

Elizabeth Lando-King, PhD, RN Elizabeth.Lando-King@state.mn.us 651-201-5632

Thank you.