What is Project Access?
A physician-led community partnership that coordinates increased access to health care for lower-income, uninsured residents of Wichita/Sedgwick County.Is designed to complement and enhance the work of existing community care clinics and other community agencies.
Coordinates care donated by local physicians, dentists, hospitals, pharmacists and other medical providers, as well as prescription and equipment assistance.
Why is Project Access needed?
Over 55,000 residents of Sedgwick County are uninsured, many of whom are working hard in one or more low-wage jobs where they are not eligible for, or cannot afford other coverage products or programs.Low-income, uninsured people often access care late in the course of illness and rarely in a coordinated or efficient way.
Project Access offers an opportunity for physicians and other providers to partner with others to increase access to care, to improve the health of enrollees and to reduce costs borne by the community.
Why should I support Project Access?
Many physicians, dentists and other health care providers are already caring for uninsured patients; others would gladly help meet this need if the burden is shared among the majority of providers.Project Access was designed by physicians and hospital leaders from within our own community. There is a special focus on the fundamental values of their profession; to demonstrate their commitment to improve the health of our community in a way that is organized, efficient and properly recognized.
How does Project Access work?
Project Access is a referral network available to eligible uninsured people who have established their primary care medical homes at the local community care clinics (Hunter, GraceMed, Center for Health and Wellness, Guadalupe, Good Samaritan, E. C. Tyree, Healthy Options for Kansas and the Sedgwick County Health Department). It is also available to participating physicians for their established patients.Project Access is designed to facilitate access to comprehensive health care services that are beyond the scope of care available at the community care clinics or in a single provider’s office.
Enrolled patients receive physician, dentist, hospital care and other services at no cost.
Enrolled patients may fill prescriptions for generic medications and diabetic supplies at very low cost. Program staff can also help patients obtain donated medication through the pharmaceutical companies as well as needed durable medical equipment.
Who is eligible to receive care through Project Access?
US citizens and lawful permanent US residents, who must reside in Sedgwick County.Those with no medical insurance coverage, including programs such as Medicaid and Medicare.
Those who have a household income that meets the program’s financial eligibility criteria.
How are people enrolled into Project Access?
At the request of health care providers at the local community care clinics.By physicians participating in Project Access, who may refer their own established patients for enrollment.
By participating residency program clinics.
How will patient visits be scheduled?
Patients enrolled through a community care clinic will have their appointments scheduled by a referrals coordinator within the enrolling clinic.The clinic’s referrals coordinator will ensure that the patient is provided with all of the necessary appointment information, including where to be and when to be there.
What happens when a patient needs a specialty referral?
Specialty referrals should be coordinated through the Project Access office.
Call the Project Access staff to request a participating physician in the specialty needed for your patient.
Project Access will assign the next available specialist.
You may call the assigned specialist to schedule an appointment for your patient.
If a patient is already established with a physician in the specialty requested, Project Access is unable to identify a new physician for a new referral. Project Access should not interfere with that doctor-patient relationship. The patient should return to the established physician even if that physician does not participate in the program.
Every effort is made to respect stable doctor-patient relationships.
What happens when I see a Project Access patient?
Project Access patients are scheduled like other patients.Each enrolled patient is issued a patient identification card and is instructed to present this card at each appointment, just like any other health benefits card.
Project Access patients are seen in your office and are provided the same care as any other patient.
You decide what services are needed for the patient; no pre-certification is required.
What happens after I have completed the patient’s treatment?
After you have finished seeing a Project Access patient who has been referred to you, please communicate with the referring physician or practitioner just as you do for any other patient in your practice.Your billing staff should submit a HCFA 1500 billing form to the Project Access office in the same way they customarily do for insurance plans.
While you will receive no payment, this form gives us a complete record of the services provided and the value of the care you have donated on behalf of the patient. We aggregate this information and report to the community the care physicians, hospitals and other providers have donated.
Who decides how many times I will see an established Project Access patient?
Together with the patient you will decide how many visits are needed.Patients may be seen as often as you deem appropriate to be sure their health care needs are met.
Patients are enrolled for six month periods.
If ongoing care is needed, patients’ enrollments may be extended at the request of their treating physicians, as long as the patient continues to meet eligibility requirements.
What if a patient needs diagnostic tests or physical therapy?
If a Project Access patient needs diagnostic tests such as laboratory studies or x-rays, you may choose to donate these if you regularly provide these in your office.If you normally refer patients to facilities outside your office for testing or physical therapy, please refer Project Access patients to the same facilities as you would any of your patients. However, some may not participate and in those instances, patients will be billed for those services.
Please call the Project Access office for assistance if you do not have a physical therapy provider or for other needs.
What if a patient needs hospitalization?
Area hospitals donate inpatient and outpatient services for Project Access enrollees, at no cost to the patient (emergency department services and inpatient psychiatric care are not included); you simply admit the patient just like any other patient.Participating area hospitals include:
- Via Christi Regional Medical Center
- Wesley Medical Center
- Kansas Heart Hospital
- Kansas Surgery and Recovery Center
- Cypress Surgery Center
- Kansas Spine Hospital
What if a patient needs medication?
Project Access enrollees receive a prescription identification card at the time of enrollment.Patients can fill prescriptions at 71 area pharmacies and pay a minimal copay per prescription which is applied toward the cost of the medication.
The program covers generic prescriptions and some name brands including insulins and diabetic supplies, asthma inhalers, Epi Pens, Tamiflu and a few others.
Participating pharmacists fill prescriptions based on a maximum allowable cost (MAC) list and do not charge dispensing fees.
What is the patient’s responsibility in the program?
Patients must document their eligibility for Project Access enrollment.Patients are responsible for attending all scheduled appointments on time.
Patients are responsible for making a good-faith effort to work in partnership with their volunteer physicians to carry out the recommended plan of care.
Patients are also asked to thank the health care providers who are generously donating their services.
I already care for low-income patients. Doesn’t this count?
Yes it does and THANK YOU!With your help, we hope to record and recognize this service.
The number of low-income, uninsured patients you are already seeing can be counted toward your Project Access pledge, if you wish to refer them for enrollment.
Simply complete and fax the patient referral form (provided to you after you submit the physician commitment card).
By enrolling your patients and committing to donate the care you provide them, you receive recognition and the ability to access, on their behalf, other donated services through the program such as hospitalization, access to other specialists and medication and equipment assistance.
Will I receive only the number of patients that I have agreed to see?
Project Access maintains a computerized referral system to ensure that only the number of Project Access patients that you have agreed to accept will be referred to you.Referrals are rotated among the physicians and other providers to assure fair distribution of patients to all the participating physicians.
Project Access will follow your instructions about how many patients you wish to receive (on an annual basis). We will track the patients you refer for enrollment and/or those referred to you.
What is my risk?
Through the Kansas Department of Health and Environment’s Charitable Health Care Provider (CHCP) Program
, health care providers who donate care to the medically indigent may be included for liability purposes under the Kansas Tort Claims Act special liability expense fund. This means those charitable health care providers are defended by the Attorney General’s office and the Kansas Tort Claims fund will be the payer of the first resort, even if another policy of professional liability insurance exists.The CHCP Program is particularly valuable for retired physicians who might wish to volunteer their services in an existing community care clinic but no longer maintain their own malpractice coverage.
Project Access is a point of enrollment for the CHCP Program. The CHCP Program enrollment form is provided with your Project Access information packet. Please return the completed form with your signed commitment card. Project Access staff will file it with the CHCP Program office and will ensure that an annual report of Project Access providers’ care is submitted.
What is asked of physicians? How can I help?
Project Access helps you put your physician compassion into action. Here is how you can help:Specialist physicians
Accept 20 Project Access patient referrals per year.
Primary care physicians
Accept 10 Project Access patients per year.
Accept 12 Project Access patients per year.
Volunteer at area community care clinics
Volunteer for 24 hours during the year. Clinics need volunteer time and expertise from specialists, primary care physicians, retired physicians, dentists and others.
Recruit physicians or participate in the planning, operation, or evaluation of the program.
How are providers recognized for their efforts?
Project Access tracks and reports all the care that is donated and ensures that the media and others hear the message. Each year, the program implements various recognition plans (notices in the MSSC newsletter, letters of thanks sent to physician offices, newspaper articles, etc) to thank our providers for committing to be part of increasing access to care, improving health outcomes and reducing costs for care for the uninsured.We have tried in this FAQ sheet to anticipate your questions about Project Access. We encourage you to call us if you need additional information. You may reach the Project Access office (co-located at the Medical Society of Sedgwick County office) by calling 688-0600 during business hours.