OHCA Online Enrollment “Easy as for SoonerCare members and partners” Richard Evans, Manager, Eligibility Automation and Data Integrity, OHCA

Online Enrollment Description Launch date: September 7, 2010 for Concept submitted to CMS in summer of Work began after approval December 2007 Web based Applicati on Streaml ines policy and proces ses Streaml ines policy and proces ses Immedi ate decisio n/ informa tion Immedi ate decisio n/ informa tion

Why Create This? Increase effectiveness and efficiency –Improve client numbering –Streamline enrollment and verification –Intuitive application with editing controls Vehicle for multiple program applications Phase I populations –SoonerCare (Children, Families, Pregnant) –SoonerPlan (Family Planning Waiver) –State Sponsored Behavioral Health

Why Create This? Eliminate barriers that prevent applications –Private, real-time determination –Online application available 24/7 –Review/renewal at any time

mySoonerCare.org Services “From the privacy of your own home…” Provide a place for individuals and families to enroll in SoonerCare coverage –New first time applicants can start an application without scheduling an appointment –Get results and enroll real-time –Select a Medical Home Provides member the ability to Manage your Account –Review your benefits –Update information

Understanding Multi-Program Interplay “Multiple vehicles for submitting and processing applications…” Agency View – provides agency partners the ability to be an eligibility broker –Search for member or applicant –Verification of documentation: i.e. pregnancy and citizenship and identity –Update and change member information –Alerts for and Assist with the reenrollment process Notification of Date of Service form – provides hospitals the ability to reserve a date of application when a full application can not be competed that day. –Allows hospital claims to be paid when a full SoonerCare application is received (within 15 days) and member is determined eligible

Understanding Multi-Program Interplay “Multiple vehicles for submitting and processing applications…” ODMHSAS provider application – provides facilities the ability to enroll applicants in state sponsored behavioral health services and assigns an ID that they will retain when they apply for SoonerCare Paper application – remain an option for applicants –Applications are scanned and data entered in system –Just as will all other application types the Rules Engine will make the eligibility decision

Putting the Pieces Together to Serve Members State Department of Health Providing eligibility resources Piloting 16 counties with the agency view application Data exchange for citizenship verifications

Putting the Pieces Together to Serve Members Department of Human Services Providing eligibility resources SoonerCare only clients assisted through agency view or mySoonerCare.org System interface for comprehensive applicants/members to allow for rules engine determination and enrollment

Putting the Pieces Together to Serve Members Indian Health – Tribal Leveraging current eligibility resources SoonerCare determination required before accessing Contract Health Services funds. Community Partners Everyone's a partner – any organization with internet and a willingness to assist Oklahomans.

Considerations for Board Ground work laid for future programs: –Insure Oklahoma, –Breast and Cervical Cancer Health Reform initiatives –Expansion of FPL –Categorical relationship removal Coordinates well with Health Information Exchange

Lessons Learned It takes a village Design tools – wireframe application utilized for focus groups and application flow A variety of approaches are critical Build partnerships and keep them alive

For More Information... Contacts Richard Evans, Manager Eligibility Automation and Data Integrity Derek Lieser, Project Manager Planning and Development