What is Project Access?
Project Access is a network of hospitals, doctors and other health care professionals who provide no cost health care for uninsured residents of Linn County in an efficient and cost-effective way. Project Access is NOT a health insurance program. Participating health care providers do not receive reimbursement for services provided.

Physician Questions
Why should a physician participate in Project Access?
How can I help?
What if I have a patient who may qualify for Project Access but is not in the program?
What is the patient’s responsibility in the program?
How does the program help individuals?
What is the benefit to the community?
What does it mean to pledge to Project Access?
What is the suggested pledge?
Can I change my pledge during the year?
How can I check my pledge level?
Why do you need a pledge?
What exactly are you asking of me?
How are my volunteer hours and donated services tracked?
Can I be assured that my pledge will not be exceeded?
What happens at the end of my pledge to my Project Access patient?
What is standard procedure for an emergency room visit or admittance?
What if a patient needs medication?
Who can receive this care?
Can I enroll uninsured, low-income patients that I am already treating?
Can you guarantee that patients will show up for their appointments?
What are the steps I take if a patient isn’t following the Patient Responsibility compliance policy?
Are interpreters available?
Can Physician Assistants and Nurse Practitioners see Project Access patients?
What about malpractice coverage?
Aren’t there other existing charity care programs?
Has this been successful in other areas?

Claims Questions
Will Project Access patients have ID cards?
What will be on the card that is required for the claim?
What if a patient presents for services without an ID card?
Can we verify enrollment online or via phone/fax?
Will the start/end date of coverage appear on the card?
Will claims be sent electronically or on paper?
Where do I send my claim processing forms?
Will we have access to the name and contact information for Project Access staff?
If patients have questions, who is the contact at Project Access taking these calls?
What type of reporting will be available through Project Access?

Operational/Business management Questions
What are the benefits of Project Access to my practice management?
What makes a legitimate patient/referral?
What are the eligibility guidelines?
How does Project Access screen and enroll patients?
How long are patients enrolled?
What if a patient needs services that I don’t provide?
Are there special forms that I need to use for Project Access patients?
Do patients pay for services?
How does Project Access track referrals and care?
How do I refer a patient to Project Access?
What role do safety net clinics play?

__________________________________________________________________

What is Project Access?

Access to comprehensive health care is become increasingly more difficult. An estimated 9,000 -10,000 people are uninsured and considered low income at any given time in Linn County, Iowa. With the rising cost of health care and other living expenses, in addition to the challenges caused by recent flooding, this number is expected to grow.
Established in 2008 and developed out of the Fifteen in 5 Access to Healthcare Collaborative, Linn County Project Access is designed to provide a coordinated system for helping uninsured people get the health care they need in the most efficient and cost effective way possible.
There are more than 50 Project Access sites throughout the country.
Focus is on maintaining a patient's relationship with their primary care physician and connecting them with specialists and other health care resources.
Project Access Goals for patients include:
• Increase health care service availability.
• Improve health care outcomes.
• Reduce unnecessary emergency room visits.
Project Access health care partners are committed to working together to connect patients with all necessary health care services.
In addition to helping uninsured people, Project Access aids physicians who want to volunteer their time and services to people who do not have access to quality health care because of their financial situation. Participating doctors demonstrate their commitment to the ideals of the medical profession by donating care through Project Access either in their office or through community health centers and free health clinics.
Project Access Goals for physicians:
• Reduce time spent referring patients to needed health care services.
• Organize and track donated health care.
• Coordinate patient financial screening and enrollment in eligible programs.
Project Access is modeled after Buncombe County Project Access in North Carolina, which was started in 1996 by Buncombe County Medical Society.
Through Project Access physicians and community partners donate their services to patients without receiving reimbursement or compensation. Project Access is not health insurance, it is however a way to help our community members stabilize their health so that health insurance is more attainable. Project Access physicians donate services from routine annual physicals to open heart surgery.

__________________________________________________________________

Physician Questions

Why should a physician participate in Project Access?
The people of Linn County who need your help are counting on your commitment to the ideals of your profession – those of community service and patient advocacy. A healthy community is good for everyone. Project Access an outstanding public relations and physician advocacy tool for Linn County physicians.
Other tangible benefits of participation include:
• Knowledge that you are providing free care to individuals who really need it.
• The ability to refer your current uninsured patients into Project Access.
• A more equitable distribution of charity care within Linn County.
• An opportunity to give back to the community and be recognized for charitable efforts.
• Public system for providing charity care without being overwhelmed with patient requests.
• Address the issue of lack of specialty care for uninsured Linn County residents.
• Specialists, rather than primary care physicians, provide appropriate care for patients with chronic conditions.
• Health care providers can treat patients without insurance the same as they treat patients with insurance.
• Specialists will provide care knowing that a patient will be able to manage their ongoing health care needs with a primary physician.
• Patients recover and stay well, and practitioners are not faced with treating the same problem repeatedly.

How can I help?
Primary care and specialty physicians are asked to pledge to accept a certain number of Project Access patients and facilitate a treatment plan for each. If you are a specialist, your suggested commitment is to accept 20 patients into your practice for ongoing or short-term care in a 12-month period.
Primary care physicians, have a suggested commitment of 10 new patients per 12-month period.
These patient commitments would include any current patients who you identify and who apply and are accepted into Project Access.

What if I have a patient who may qualify for Project Access but is not in the program?
Have the patient contact Project Access staff at (319)892-6083 or you or your staff will need to complete the referral form and fax to the Project Access office at (319)892-6098.

What is the patient’s responsibility in the program?
Patients who meet the eligibility requirements and complete the application process are then asked to sign a contract agreeing to meet certain responsibilities. These include being responsible for keeping appointments and making a good-faith attempt to partner with their doctor and carry out the recommended plan of care.

How does the program help individuals?
Project Access fills a need for people who do not have private health care insurance but do not qualify for government health care programs. Project Access does not duplicate existing federal, state or local program services, but instead improves local access to specialty care by complimenting and working in partnership with other health care initiatives.
The focus is on creating and/or maintaining a patient’s medical home: a relationship with a regular primary care physician who coordinates patient care and helps manage ongoing health concerns and chronic conditions).

What is the benefit to the community?
Studies have shown that in Project Access communities, costly emergency room visits decrease, which helps to keep overall health care costs down; patients make fewer visits to community health care facilities, which increases the number of patients served; and doctors spend less time overcoming obstacles to providing free care for their patients, which means they may be more likely to provide free care to others. Project Access patients are more likely to regularly visit their primary care doctor and get connected to specialty care when they need it.

What does it mean to pledge to Project Access?
A pledge consists of a completed medical treatment plan for each patient. There may be multiple appointments and services related to the completion of each treatment plan. By pledging, you are giving a self-determined level of commitment as to the number of new Project Access patients you will accept during the next 12 months. These are both patients you identify through your office as well as referrals from other Project Access physicians and safety net clinics providing primary care. Your commitment helps Linn County’s charity care network run more smoothly and efficiently.

What is the suggested pledge?
Primary care physicians are asked to accept 12 new patients into their practice and specialty care physicians are asked to accept 10 new patients in a 12-month period.

Can I change my pledge during the year?
Yes. If the needs of your practice change during the year, you can adjust your pledge level to meet these needs by contacting the Project Access office. We are also able to “hold” your pledges for times that you may not be able to take patients. For example, there may be times when you will be out of the office for an extended period of time.

How can I check my pledge level?
The Project Access database tracks each physician’s commitment. You can contact the Project Access office at (319)892-6083 at any time to check your pledge level.

Why do you need a pledge?
By knowing your commitment and the commitment of your colleagues, Project Access can form a charity care network in Linn County and make it run as efficiently. By having your pledge, we are able to respect your self-determined level of commitment. Communicating the amount of available resources and referrals to referring physicians helps these physicians diagnose and design a treatment plan based on the available resources. Once you have completed your pledged commitment for the year, Project Access patients will not be referred to you.

What exactly are you asking of me?
We ask a commitment to see the number of yearly patients you have pledged to at no cost to them. These can be current patients who qualify and are accepted into Project Access or new referrals through Project Access.

How are my volunteer hours and donated services tracked?
Project Access has a central enrollment and scheduling database. Patients are required to present their Project Access ID cards when health care services are rendered. Office staff submit a standard billing invoice to the Project Access office by mail or electronically -- the same way you treat other insurance plans -- except you will not receive payment. This will help Project Access track donated hours and value while better ensuring that referrals are equitably distributed among participating physicians.

Can I be assured that my pledge will not be exceeded?
Project Access will maintain our database to assure that only the number that you have agreed to accept will be referred to you. When your office staff submit a standard billing invoice, we note that patient under your pledge. Referrals rotate in order to ensure equal distribution of patients across participating physicians.

What happens at the end of my pledge to my Project Access patient?
If you decide to no longer participate in Project Access or no longer see a patient that still requires care, please notify Project Access staff. A new Project Access physician can be located for the patient. If you decide to discharge the Project Access patient, please follow standard protocol for discharging a patient from your practice.
If the patient’s eligibility expires, you may continue to see the patient at your own expense, and without having to send standard billing invoices to Project Access. This donated care will not be tracked by Project Access.

What is standard procedure for an emergency room visit or admittance?
Project Access does not cover emergency room visits. If a patient has an emergency or needs to be admitted to the hospital after normal business hours, the patient should go to the nearest emergency room and the hospital will provide treatment by following its normal charity care procedures.

What if a patient needs medication?
Community partners are currently working together to create a Project Access prescription assistance program that builds on the current programs available in Linn County. Patients in need of medications will be connected with available Pharmacy Assistance Programs (PAP).

Who can receive this care?
To be eligible for Project Access, patients must be residents of Linn County, be uninsured and income limit is 200% of federal poverty level. They must complete the Linn County Project Access Financial Statement Application, Linn County Project Access Enrollment Application. In addition, they must complete an Iowa Care application to be recommended for other available programs for which they may be eligible.

Can I enroll uninsured, low-income patients that I am already treating?
Yes. If you are currently providing care for a low-income, uninsured patient who you feel would meet eligibility requirements for Project Access, please contact our staff at (319)892-6083. If the patient is eligible, we will enroll them in Project Access and give you credit toward your pledge for their treatment.

Can you guarantee that patients will show up for their appointments?
Patients go through an orientation and sign a Patient Responsibility Form with Project Access agreeing to keep all appointments. Project Access staff will work to help patients address barriers, such as lack of transportation, so that they can keep their appointments. Patients can be discharged from the program for poor compliance, such as too many missed appointments.

What are the steps I take if a patient isn’t following the Patient Responsibility compliance policy?
The Patient Responsibility Form that a patient signs upon enrollment clearly states that he/she needs to follow the compliance policy – including attending appointments, following physician instructions and treatment plan, etc. Project Access will leave it up to the discretion of physicians to determine when they feel a patient is noncompliant. We can help to coach a patient if you let us know there is an issue. Please contact Project Access staff at (319)892-6083.

Are interpreters available?
If necessary, Project Access staff will arrange a medical interpreter to accompany non-English speaking patients to their appointments.

Can Physician Assistants and Nurse Practitioners see Project Access patients?
Yes, the mid-level providers in your office can provide care for Project Access patients when appropriate.

What about malpractice coverage?
The Iowa Department of Public Health provides assistance through its Volunteer Health Care Provider Program. Forms necessary to receive assistance through this program are available in the Provider Information Packet or by calling the Project Access office.

Aren’t there other existing charity care programs?
A significant amount of charity care is offered by the Linn County medical community, but until now, it has not been systematized or property recognized. Project Access works in partnership with established charity care programs and plans to quantify all charity care being provided in Linn County. Our goal is to expand the number of physicians providing charity care.

Has this been successful in other areas?
Project Access began in Buncombe County, North Carolina, which has been very successful with an 85% participation rate from local physicians. The total value of charity care provided by Buncombe County hospitals was reduced by 15% over a three-year period, as uninsured patients were able to obtain preventative and primary care services.
• 80% of Project Access patients reported that their health was better or much better after Project Access,
• 25% reported that Project Access helped them return to work
• 50% of former Project Access patients eventually acquired health insurance.

__________________________________________________________________

Claims Questions

Will Project Access patients have ID cards?
Yes. The card is your assurance that the patients have met the qualifications for charity care.
What will be on the card that is required for the claim?
The ID card will have a patient’s name, birth date, Project Access ID number, and expiration date.
What if a patient presents for services without an ID card?
If the appointment has been scheduled prior to the ID card being printed, you can call the Project Access office at (319) 892-6083 to confirm eligibility.
Patients will receive orientation and be asked to sign a contract agreeing to meet their responsibilities to the program, including the importance of having their ID card with them at the time of service. Patients will be told that if they do not have their card at the time of service they may not receive services or if they do, they may be billed for those services.

Can we verify enrollment online or via phone/fax?
We do not have the capability to provide on-line verification of enrollment. You can call Project Access staff at (319) 892-6083 to verify enrollment.
Project Access staff will make the initial appointment with the participating physician’s offices. Patients cannot self-refer to a Project Access physician.

Will the start/end date of coverage appear on the card?
Yes. A patient’s eligibility expires six months from the day of enrollment. On or before that date, a patient can contact the Project Access to request an extension. The request is considered only after the patient’s primary care physician has completed the Project Access Physician Recommendation Form, which the Project Access staff will fax to the physician.

Will claims be sent electronically or on paper?
Ideally you would send them electronically; however, either will be accepted.

Where do I send my claim processing forms?
Claim forms can be sent to: Project Access, c/o Healthy Linn Care Network, 501 13th St NW, Cedar Rapids, Iowa 52405. Please make sure that the patient ID# is included on the claim form.

Will we have access to the name and contact information for Project Access staff?
Each physician’s office will have direct contact information to a Project Access staff member.

If patients have questions, who is the contact at Project Access taking these calls?
You will be provided direct contact information to a Project Access staff member fielding patient questions/concerns.

What type of reporting will be available through Project Access?
The software allows us to “slice and dice” our data as many ways as we would like. Reports can be created by Project Access staff upon request by partner physicians.

__________________________________________________________________

Operational/Business Management Questions

What are the benefits of Project Access to my practice management?
There are several benefits to a practice/clinic that signs up their physicians including:
• As the health of uninsured individuals improves, overall cost of charity care declines.
• Easier access to other specialty referrals and ancillary services reduces your and your staff’s follow-up time.
• Reduction in no-pay, no-show patients will increase paying patient volume.
• Objective third party review of patient finances reduces your practice staff time spent conducting patient financial assessments.
• Collection efforts can be focused on collectable accounts rather than trying to collect from patients that are unable to pay.
• Accounts receivable will more accurately reflect assets.
• Documentation of your charity care helps to secure community funding for medications, durable medical equipment and other support for low-income, uninsured patients.
• Software allows clinics access to reports that will assist in their reporting and marketing efforts.
• The participation of the physician community in Project Access catches the attention of legislators and policy makers. These policy makers are more apt to attend to physician issues such as tort reform, Medicare and Medicaid reimbursement rates, mental health reform, and other issues that are important to Linn County physicians.
What makes a legitimate patient/referral?
When in doubt, make the referral and let Project Access staff handle the enrollment process.

What are the eligibility guidelines?
To be eligible an individual must meet the following criteria:
• Are at least 19 years old, uninsured and have an immediate medical need
• Do not qualify for any government health care programs
• Household income is at or below 200% of federal poverty level guidelines
• Proof of Linn County residency

How does Project Access screen and enroll patients?
We use a financial screening form -- the Linn County Project Access Financial Statement Application -- that is used by both Cedar Rapids hospitals, and Linn County Project Access Enrollment Application

How long are patients enrolled?
Enrollment is for six months, but patients can re-enroll at the end of that time period if still eligible.

What if a patient needs services that I don’t provide?
Contact the Project Access staff at (319)892-6083 for a referral to another health care provider.

Are there special forms that I need to use for Project Access patients?
No. Regular insurance claim forms are used but the office must write off the cost of services rather than bill the patient.

What are the patient responsibilities?
A list of patient responsibilities are attached to this document and provided to each patient upon their enrollment into Project Access.

Do patients pay for services?
No. Patients are not billed for Project Access services. Your office will need to write off the expenses associated with treating Project Access patients.

How does Project Access track referrals and care?
Software maintained at the Project Access office tracks referrals and care provided. An annual report can be provided to your office outlining the amount of charity care you provide to Project Access patients each year.

How do I refer a patient to Project Access?
If you are currently providing care for a low-income, uninsured patient who you feel may meet eligibility requirements for Project Access, please contact our staff at (319)892-6083. If they are eligible for Project Access, we will enroll them and give you credit toward your pledge for their treatment.

What role do safety net clinics play?
Optimally, each Project Access patient will be connected with a medical home or a primary care provider that coordinates the patient’s care and is able to follow up with the patient following their visit with a specialist. Free medical clinics may refer patients to Project Access and every effort will be made to connect the patient with a medical home prior to a visit with a specialty care physician in order to ensure more comprehensive provision of services.

For Physicians > Physician FAQs