After completion of the application process, HCR makes use of Cúram Universal Access to provide an eligibility results page for the range of HCR programs that a citizen and household can enroll in. The results of the eligibility determinations are prominently displayed in an easy-to-use interface. Help is available for terminology that is of significance to the individual in making decisions that best address the needs of the household.
The HCR eligibility results page is logically broken up into a number of discrete sections. The top panel displays the applicants in the household and provides summary information on the programs they are eligible for, as well as the enrollment status. 'My items' retains details of the enrollments that have been processed. The main page content consists of three main sections:
The health care options are displayed front and center on the eligibility results page as they relate directly to the reason the individual is here - to get health care coverage whether through state-administered Medicaid/CHIP or using the federal assistance for health insurance. The options available to an individual obviously depend on the results of the eligibility determination for insurance affordability programs. The citizen can choose to view details about the eligibility result. The opportunity to continue by shopping for and selecting plans for enrollment are presented, however plan selection and enrollment is handled by a plan management system, explained in more detail later. Upon completion of enrollment, an individual is returned to the eligibility results page and can view summary enrollment details.
Screening results that a citizen may avail of are displayed below the health care options. Individuals have the ability to use the screening results to apply for other government services if offered in-state and configured to be made available as part of the Health Care Reform solution. For example, a low-income single mother could be determined potentially eligible for Food Assistance or Cash Assistance; the mother can continue to apply for one or all of these programs; this functionality reiterates the "no wrong door" approach provided within HCR.
Other community services are highlighted in a map for services within reach of the individual. These services are shown as a result of triage, generally the first interaction a citizen has with an agency which quickly identifies an individual's needs. For example a client may have an immediate need for food and shelter for the family. Triage will quickly identify these needs and provide details of suitable services on the triage map so that a citizen can easily identify the locations of the services being provided.
Note: OOTB there is nothing provided for the 'Other Community Services' section, this is left to customers to use if they wish.
Citizens that do not directly enroll on a plan can submit their applications to be further processed by case workers. Upon submission, an application reference number is provided to the applicant. Completion of enrollment in a QHP, or submission of the application invokes the intake process in the back-end case management system. Information gathered in the application is mapped to evidence on an application case, which is the vehicle used to represent the information captured at the time of application. Additional details are available in the chapter 'Working with Client Applications'.