Warrior Navigation & Assistance Program. Faye Lane, Nurse Navigator Stacy Stover, Health Care Navigator
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1 Warrior Navigation & Assistance Program Faye Lane, Nurse Navigator Stacy Stover, Health Care Navigator
2 Warrior Navigation & Assistance Program Mission Goal Overview Approach Warrior Support Family Support Coordination & Navigation Federal Recovery Coordinators Military Treatment Facilities Veterans Medical Centers Contacts Promise 2
3 Mission To provide guidance and clinical support to military and civilian health care professionals with treatment, rehabilitation and reintegration of recovering warriors enabling them to return to active duty or back home to the community as productive veterans. To help guide recovering warriors and their families through the maze of healthcare systems. To connect recovering warriors and their families with available resources that can help them resolve issues. 3
4 Goal To advocate on behalf of the recovering warrior and their family to ensure they meet all their goals whether physical, behavioral or social. No issue goes unresolved. 4
5 Overview Guidance Connecting Resources Problem Solving for Recovering Warriors & Families 5
6 Approach Holistic view of recovering warrior s needs Based on an assessment and evaluation Specialized multi-disciplinary team Separate Line GO-WNAP ( ) Four Pronged Approach Assist in navigating through government systems Education on health care benefits Systematic problem solving Clinical care coordination 6
7 Warrior Support Medical billing and claims issue resolution Navigating TRICARE, Medicare and Veterans system health care benefits Assistance in locating specialized medical equipment Connecting with resources to meet basic needs (food, shelter, transportation) Linking with behavioral health resources Assistance with transitional care when relocating 7
8 Family and Care Giver Support Medical billing and claims issue resolution Respite Care Connecting with resources to meet basic needs (food, shelter, transportation) Linking with behavioral health resources Guidance on Health Care Benefits 8
9 Coordination & Navigation Referral/Authorization Coordination Region to Region Specialized Durable Medical Equipment or Home Modification Transition from Active Duty Options Navigation through TRICARE VA Medicare Medicaid Private Funding Intervention with Pharmacy 9
10 Federal Recovery Coordinators VA Employees Assigned to MTFs or Other Sites who Manage the Most Seriously Injured Based on Fixed Criteria Liaison Between FRC and WTU for Warriors Enrolled to the Federal Recovery Program Seven FRCs Located in the South Region (Case Load is Not Region Based) Brooke Army Medical Center, Fort Sam Houston (3) VA Houston (1) Eisenhower Army Medical Center, Fort Gordon (2) VA Tampa (1) 10
11 Military Treatment Facilities Warrior Transition Units Assist with Enhanced Standards when Difficulties are Encountered Assistance with Urgent Referrals to Specialist Challenging Cases Eligibility, Enrollment, Provider Location, Non-Covered Services, Unique Referrals Other Government Program Guidance Liaison and Coordination 11
12 Community Based Warrior Transition Units Health Care Navigator Assigned to Each CBWTU Monthly Meetings Quarterly Musters Expedited Enrollment Difficult Network Appointments Liaison with Military Medical Support Office for Expedited Approval Claims Resolution Enhanced Access Standards Consult Result Assistance Coordination Between WTU and CBWTU 12
13 Veteran s Medical Centers Liaison Between MTF and VA Referrals for MOA (TBI, SCI, Blind Rehab, and Polytrauma) Monthly Meetings Claims Resolution Referral Assistance 13
14 Civilian Providers & Facilities Advise on Wounded Warrior Issues Non-Covered Service Claim Filing Assistance Liaison Between Warriors and Providers Liaison Between VA and Providers Liaison Between MTF and Providers 14
15 Points of Contact GO-WNAP ( ) Health Care Navigator Nurse Navigator 24/7 Messaging Margaret Wilson, RN, CCM - Supervisor Kirsten Dugan, RN - Manager 15
16 Summary Mission Goal Overview Approach Warrior Support Family Support Coordination & Navigation Federal Recovery Coordinators Military Treatment Facilities Community Based Warrior Transition Units Veterans Medical Centers Civilian Providers Contacts 16
17 Promise Providing guidance and assistance to recovering warriors and their families when they need it the most. 17
18 18
19 Insert Section Slide Title 19 Proprietary Proprietary to Humana to Humana Military Military not to not be to disclosed. be disclosed.
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