Healthcare Reform: What Do I Do to Get Insurance?
A Healthcare MBA Tutorial
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Simply,
keep it simple. This is the idea behind helping Americans sign up for insurance. The Affordable Care Act has not been praised
for being straight forward however it was made clear that the process of
signing up for healthcare should be as easy as possible for everyone to use. This
tutorial will explain all the steps that go on behind the computer screen. (Since
I am obtaining my MBA in Healthcare at Baylor University in Texas I will use
Texas’ Insurance Exchange in this tutorial.)
A. The user will input some different
information, including social security number, date of birth and other
demographics.
B. The demographic information then
moves to the Texas Exchange almost directly sent away
C. The demographic information is then
sent to the Department of Health and Human Services, a Federal Organization the
demographic information is then sent to be confirmed
D. The demographic information is then
sent to the IRS (Internal Revenue Service)
E. The IRS then sends a request to
provide income history to the Department of Health and Human Services (DHHS)
F. That request of income history
filtered through the DHHS is then sent to the Texas Exchange
G. The Texas Exchange takes the inquiry
of income history and sends a request to other states and third parties. For
example to check unemployment, child support, credit bureaus etc.
H. After the Texas income history,
other state and third party organization data has been collected it is sent
back to the Texas Exchange where it is aggregated and reconciled.
I.
The
compiled data is then sent back to the consumer, the American signing up for
the insurance. They need to confirm the information.
J.
The
consumer then must offer any information available about employer health
insurance programs available to them.
K. This information about employers from
the consume is sent to the Texas Exchange
L. The Texas Exchange then takes the
employer information and sends it to the consumer’s employer for confirmation.
M. The employer than confirms the
employee and verifies if the employer is using insurance options. The employer
also verifies any tax credit and/or Medicaid eligibility. This information is
then sent to the Texas Exchange.
N. The Texas exchange takes the
employer information and sends insurance plan options and premiums with the
consumer.
O. The consumer then can choose from the
available plans afforded to them their selection is then finally sent to the Texas
Exchange, where it is recorded.
The purpose
of this tutorial is to help Consumers, Health professionals and MBA Healthcare students
understand the process of applying for and receiving insurance through the
Affordable Health Care Act. With all the changes in healthcare it has given me
a lot of interesting and applicable information to study and share while
gaining an MBA in Healthcare from Baylor University.
E. The IRS then sends a request to
provide income history to the Department of Health and Human Services (DHHS)
G. The Texas Exchange takes the inquiry
of income history and sends a request to other states and third parties. For
example to check unemployment, child support, credit bureaus etc.
J.
The
consumer then must offer any information available about employer health
insurance programs available to them.
N. The Texas exchange takes the
employer information and sends insurance plan options and premiums with the
consumer.
The purpose
of this tutorial is to help Consumers, Health professionals and MBA Healthcare students
understand the process of applying for and receiving insurance through the
Affordable Health Care Act. With all the changes in healthcare it has given me
a lot of interesting and applicable information to study and share while
gaining an MBA in Healthcare from Baylor University.
Very informative article, very discouraging process.
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