SUBJECT
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Approve the Renewal Amendment with Experian Health, Inc. (estimated annual amount less than $100,000)
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DESCRIPTION
Community Health Care administers the County’s healthcare safety net program, including the Polk HealthCare Plan, for the benefit of qualified Polk County residents. The Polk HealthCare Plan aims to provide healthcare coverage for clients who may otherwise lack access to viable insurance options due to income constraints or other factors. Community Health Care must validate that clients have no other insurance coverage including private insurance or employer-sponsored plans. This validation is essential to avoid duplicating coverage and to ensure that resources are allocated to those who truly require assistance. Currently, Community Health Care utilizes Experian Health, Inc. to provide real-time eligibility verification. However, verification is limited to confirming Medicaid and Medicare enrollment. This limitation creates a risk of overlooking other coverage, potentially leading to improper enrollment.
The amendment expands the verification process to identify commercial insurance coverage for Polk HealthCare Plan applicants/members and will now include insurance verification for clients enrolled with funded grants and aid programs. Community Health Care’s Member Services Section will identify applicants’ insurance coverage during the eligibility review process through Experian’s portal. An automated monthly batch report will be submitted to identify any new insurance coverage for Plan members or program clients.
The amendment will be in effect upon execution.
RECOMMENDATION
Approve the Renewal Amendment with Experian Health, Inc.
FISCAL IMPACT
Funds are available in the Indigent Health Care Fund.
CONTACT INFORMATION
Joy Johnson, Administrator, Health & Human Services Division, (863) 534-5204