December 15, 2008
Helping the Alaska Native Community with Third Party Payers
Enrolling in health care programs can help you and the Alaska Native health care system
Have you ever wondered if there was something you could do to help strengthen and enhance the services available for your children, elders, aunts, uncles and other relatives?
Enrolling in insurance programs like Medicaid, Medicare, Disability or private insurance helps pay for medical bills and increases the flow of resources to expand YKHC's services. These resources benefit the entire Alaska Native Community.
YKHC is a nonprofit health care organization that works with local communities-Bethel and over 50 rural villages-to treat illness and injury and promote wellness for the entire service area. To continue providing high-quality services for our vast region, we depend on more than just Indian Health Service (IHS) funding. The organization depends on an active partnership between health care providers, employees, and the customers who use and benefit from the system.
With only minimal increases in IHS funding each year, the Alaska Native Health system must rely on a mix of other funding sources to provide its full range of services. Roughly 50 percent of all services would not exist if YKHC relied on IHS funding alone.
Here's how you can help!
In addition to grants and private insurers, there are third-party insurance payers such as Family Medicaid, Denali KidCare, Prenatal Denali KidCare, Under Twenty-One Medicaid, Elderly Assistance/Social Security, Medicare and Disability insurance. Every time a YKHC customer provides his or her insurance information to the hospital or clinic, additional funding for Native Health services is brought into the organization at no cost to the customer. All of this money is used to fund YKHC's clinics and programs, and to buy medical equipment, medicines, and supplies needed for our services.
Third party insurance payments make a big difference in the services YKHC can provide, but there are many missed opportunities to access resources. When someone goes outside of the IHS system, does not volunteer to share insurance status, decides not to participate in screening, or does not apply for insurance or assistance they are eligible to receive, money is lost that could have supported Alaska Native Health care.
Erica Srisanceha, project manager in the Anchorage Native Primary Care Center (ANPCC) administration, cautions customers about making assumptions regarding their eligibility. "A lot of customers assume they are over the income qualifications and decline to speak with Family Health Resources (FHR) because of that," she said. "They may still qualify! The best way to find out is to apply, even if they already have private insurance."
Health Resource Representatives offer assistance
Customers are encouraged to find out if they qualify for enrollment in a free insurance program. YKHC's Health Resource Representatives offer friendly customer service and can assist in the entire enrollment, re-enrollment or renewal process. Every six months, all customers receive information about the process, a screening for eligibility and assistance with the application, if eligible. Customers can also ask for help throughout the year. If a customer prefers to fill out the application without help, mail-in applications are available.
The IHS's annual budget is set at levels below what is needed to fully meet the needs of the Alaska Native Community. The journey to wellness is traveled in shared responsibility. Customer/owners play an important role in every part of YKHC's programs and services, including funding. So, the next time a YKHC customer service representative asks to speak with you about eligibility for outside resources, the best thing to do, for your family, your friends and your community, is to take a few minutes to find out how they can help.
To contact the YKHC Family Health Resource program, please call 907-543-6470
Some Myths and Facts about Third Party Payments
Myth:
It doesn't matter if I apply for Medicare, Medicaid or Denali KidCare, or disclose my private insurance coverage-I am entitled to Indian Health Service (IHS) coverage, free of charge!
Fact:
You are entitled to IHS coverage, but your Medicare, Medicaid, Denali KidCare and disability or private insurance matter a great deal. Customer/owners who enroll in other insurance programs help the entire Native Community by bringing in additional resources and freeing up IHS funds for improvements to services. Customers don't have to pay deductibles or co-payments, regardless of what they sign up for.
Myth:
Applying for Medicare, Medicaid or Denali KidCare coverage is too complicated and isn't worth the time it takes to sign up.
Fact:
YKHC Family Health Resource Representatives can check a customer's eligibility for other insurance coverage during a quick screening, and then, if eligible, will help with the application process to keep it simple. There is no cost to the customer, and the benefit to the whole Native Community is significant. To contact the YKHC Family Health Resource program, please call 907-543-6470.
Myth:
I go to a medical center outside the Alaska Native health system because I have private insurance coverage. This way, I am freeing up a spot for someone without insurance who really needs the care.
Fact:
Customers and employees have created a world-class health system for all Alaska Native and American Indian people in our region. If you are eligible, using the Alaska Native health system for all of your health care supports it financially and honors the work that we do. Using your insurance in the Alaska Native health system brings in important funding needed to maintain and improve services for everyone.
