Step By Step In Project Access

Patients
1.Eligibility—Project Access eligibility is determined by family income, county of residence, employment, and insurance status.

2.Enrollment—Patients are enrolled in Project Access Dallas by an enrollment coordinator from the enrollment site. The patient will receive a Project Access ID card that will indicate that he is officially in the program.

Physician Office Staff

The following steps will help volunteer PAD physicians and their practices, when accepting a PAD patient.

1. The PAD physician and ancillary network manager will provide an orientation for you and your staff, before any patients are assigned to the physician. At that time you may consider designating a contact person in your office for us to call when we schedule appointments for PAD patients.

2. For PCP appointments, at the time of the patient’s enrollment into the program, an Enrollment Coordinator will call to schedule the patient’s initial appointment with your office. After the initial appointment, all other PCP appointments can be made by the patient, rather than the enrollment coordinator. However, please note that for specialty, ancillary and hospital referral requests, the patient’s PAD PCP, must complete a PAD Referral Request Form and fax it to Sharka Jones, Project Access physician and ancillary network manager at 214-941-3351. Ms. Jones and her team will schedule all specialty, ancillary and hospital referral requests for PAD. After the appointment(s) have been made, your office will be notified by fax regarding the patient’s appointment information. PAD will also notify the patient of all specialty, ancillary and hospital appointments made on behalf of the physician who requested the procedure.

3. PAD patients should receive the same experience as an insured patient. Schedule PAD patients as you would any other patients.

4. Patients must show a current PAD ID card at each office visit (see front of card for expiration date). If the patient does not have a current PAD ID card, you may call a PAD staff member from 9 a.m. and 5 p.m. Monday through Friday at DCMS to verify enrollment (214-413-1439).

5. Do not bill patients for PAD services. Your physician has agreed to provide these services as a goodwill gesture in the community. However, to track the care contributed, practices are asked to submit a standard HCFA 1500 claim form for services provided to:

Project Access Dallas Claims
5919 Greenville Ave Ste 326
Dallas, TX 75206

6. At checkout give patients a PAD Patient Payment Form in place of requesting a co-pay. Instruct them to mail the payment to the address on the form. Project Access Dallas patients are requested to donate $5 per office visit, which goes directly to the pharmacy program. Your office is not responsible for collecting this money.

7. To report NO SHOWS or patient non-compliance, contact Sharka Jones, Project Access Dallas physician and ancillary network manager, at 214-413-1439 or via email at sharka@dallas-cms.org.

8. REPORTING
PAD office tracks all commitments of physicians. Physicians can contact the PAD office to obtain a report of their patient list/commitments and remaining commitments.

9. MEDICATION
Patients enrolled in PAD are given a PAD Caremark pharmacy card, which is honored at any of the 40,000 retail pharmacies that accepts Caremark within the United States. Patients will be required to pay a $10 co-pay for each prescription at the pharmacy. The card is valid as long as their enrollment in PAD has not expired. The expiration date is listed on the PAD ID card. All prescriptions automatically will default to generic because of our generic only formulary. However, occasionally, a brand-name drug does not have a generic alternative or the physician might feel that it is therapeutically necessary for the patient to receive the brand name drug. In those cases, the physician will need to fill out a Brand Over Generic Request Form, which he can be obtained from Connie Webster, director of Project Access Dallas/community service, at 214-413-1426 or download the PDF Form here.

11. HOSPITALIZATION
For hospitalization, prior approval from the hospital access services and authorization from the DCMS Medical Director are required. Contact Sharka Jones, Project Access Dallas physician and ancillary network manager at 214-413-1439.

12. LABS
Physicians may donate lab services provided in their office to PAD patients. However, PAD has a relationship with LabCorp to provide services for PAD patients. Please note that even if the physician is a LabCorp client, the physician still will be required to sign the Indigent Contract Agreement Form so a new account number will be generated specifically for use with PAD patients. If you have questions, contact Connie Webster, director of Project Access Dallas/community services at 214-413-1426, or connie@dallas-cms.org.

13. RADIOLOGY
Physicians may donate radiological services provided in their office to PAD patients. However, PAD has a relationship with certain radiology centers to provide services for PAD patients. However, these services are limited. To schedule a radiological service, complete a PAD Referral Request Form and fax it to Sharka Jones, Project Access physician and ancillary network manager at 214-941-3351.

14. ENROLLING PATIENTS FROM YOUR PRACTICE
By enrolling in the program, Project Access Dallas physicians also can enroll a limited number of their personal patients who qualify for the program. These can be patients they already are treating for free and can get “credit” for seeing them, as part of their pledge in participating in Project Access Dallas. For more information, contact Kambria Kennedy, Project Access Dallas utilization manager, at 214-413-1440 or kambria@dallas-cms.org.