There are four (4) steps to enrolling to AllCARE for Seniors.
INTAKE – Intake usually starts when you or someone in your family, or even someone from an agency, calls AllCARE for Seniors to talk about your medical needs. This call lets us know if you might be eligible to be a participant. We will come to your home to talk to you and explain our program. We will also assess your medical needs and decide if our program is right for you. During this visit, you will learn:
- About the Enrollment Agreement.
- How the AllCARE for Seniors program works, the services we offer, and the answers to any questions you may have about us.
- That if you enroll, you must agree to get all your health care from AllCARE for Seniors.
- An estimate of your monthly cost, if any.
After this visit, if you are interested in becoming a participant in AllCARE for Seniors, a member of the Interdisciplinary Team will discuss your health care needs with other Team members and arrange a visit for you at our PACE Center, so you can get to know us and we can get to know you and learn about your special needs.
Prior to your visit to the AllCARE for Seniors PACE Center, the Intake Coordinator will contact the Nursing Facility Pre-admission Screening Team to determine whether you meet the level of care criteria required to be eligible for PACE. If you do not agree with the decision by the Pre-admission Screening Team, you may appeal the decision by writing to the Appeals Division, Department of Medical Assistance Services, 600 East Broad Street, Richmond, Virginia 23219 within thirty (30) days of receipt of your decision letter.
We will ask you to sign the enrollment agreement.
We will also ask you to sign a paper giving us permission to get all of your medical records from doctors you have seen so we can get a complete picture of your health condition.
ASSESSMENT - Each Team member will complete an individual assessment of you, review your records, and the entire Team will meet to discuss your care needs. At this meeting, they will create a plan of care just for you.
SCHEDULING THE FAMILY CONFERENCE - After we have an opportunity to discuss your needs, a staff member will call you and your family, or someone close to you, to set up a meeting to discuss the best kind of care for you. If the Team agrees that you are eligible, and if you like the AllCARE for Seniors Center after your visit there, it will be time for you to officially enroll in the program.
ENROLLMENT (FAMILY) CONFERENCE AND PRELIMINARY APPROVAL - An Interdisciplinary Team member will meet with you to talk about enrolling in AllCARE for Seniors. You can choose to have your family or a caregiver attend this meeting. We will discuss:
- The plan of care the Interdisciplinary Team feels you need and how your family will be a part of it.
- Your monthly costs, if any.
- The “Lock-in” feature - when you are an AllCARE for Seniors participant, you will be cared for by your Team. This special Interdisciplinary Team will do everything it can to keep you as healthy and active as possible. This means that once you are an AllCARE for Seniors participant your health care services will be provided only through AllCARE for Seniors. These services will be approved by members of your Interdisciplinary Team. As an AllCARE for Seniors participant, all health care services are provided and arranged by your Interdisciplinary Team. If you receive medical services from an out-of network provider without prior authorization (with the exception of emergency services), you may be fully liable for the cost of those services.
- If you are eligible for Medicare and/or Medicaid, AllCARE for Seniors takes the place of the standard Medicare and/or Medicaid programs. The only payment each month Medicare and/or Medicaid pays is to AllCARE for Seniors. They will not pay other providers because you may only be enrolled in one Medicare or Medicaid program at a time.
FINAL APPROVAL – If you decide to be an AllCARE for Seniors participant, we will ask you to sign the Care Plan signature sheet. After you sign it, you will receive:
- Your ALLCARE FOR SENIORS CARD. This card identifies you as a participant in the AllCARE for Seniors program.
- The EMERGENCY MAGNET. This magnet should be placed on or near your telephone. This keeps it handy when you need it most. The magnet shows the numbers to dial in case of an emergency.
- The EMERGENCY PLAN. This detailed sheet that you sign has instructions on “what to do” in case of an emergency.
- Your copy of the ENROLLMENT AGREEMENT SIGNATURE SHEET and Care Plan. This must be signed before you can receive AllCARE for Seniors services.
- Your signed ACKNOWLEDGEMENT OF THE CARE PLAN that your Interdisciplinary Team designed for you.
- Your PACE CENTER information which includes your scheduled days of attendance to the AllCARE for Seniors Center.
- Your INTERDISCIPLINARY TEAM information.
- AllCARE for Seniors CONTRACT PROVIDER list.
- A CONFIDENTIALITY STATEMENT.
- An IMMUNIZATION CONSENT form.
- Information about “WHAT TO BRING TO THE PACE CENTER” and other helpful information.
You have the right to file an appeal any time services are denied, reduced, or terminated, or if you disagree with an involuntary disenrollment decision.(See IDT tab: Appeal Procedure)