Frequently Asked Questions: Members
Q. What is the AMCCI program?
A. The Alaska Medicaid Coordinated Care Initiative (AMCCI) is an exciting new program offered by the Division of Health Care Services (DHCS). It provides one-on-one case management services and helps members to obtain health care in the appropriate setting. The AMCCI will assist our members to navigate the health care system and appropriately use the benefits of the Alaska Medicaid program.
Q. How is the AMCCI going to help me?
A. Case managers will assist members to coordinate their care in collaboration with their medical providers. Your assigned case manager will become your advocate to assist you to meet your health care needs. Our goal is to help members feel better and be healthier. Members will receive:
- An assigned one-on-one case manager
- An evaluation of your health care needs
- A plan to obtain the health care and support you need
- Advocacy from your case manager
- Primary care providers
- Referrals to providers & specialists, as needed
- Assistance in getting care in the appropriate setting
- Assistance getting transportation
- Assistance getting housing
- Education about your medications & health care conditions
- Additional support to obtain and access health care needed
Your case manager will work with your current physicians and providers to ensure you are able to access the health care you need based on your medical condition. All AMCCI members will continue to get all medically necessary Medicaid-covered health care services.
After you sign up for participation in the AMCCI, a welcome package about the program will be sent to you and a case manager will be assigned to work with you.
Q. Why was I chosen for the AMCCI?
A. Due to your use of Emergency Room visits, when compared to other Alaska Medicaid members, you were identified for referral to the Care Management Program (CMP) for evaluation to see if you meet guidelines for possible placement in the CMP. For more information on the Care Management Program.
Normally, this use requires further review to determine if your use should be restricted to one medical provider and one pharmacy as allowed under Medicaid regulation 7 AAC 105.600. However, you may instead choose to voluntarily participate in this new program, the Alaska Medicaid Coordinated Care Initiative (AMCCI).
Q. Can I keep my current providers?
Q. How long will I be in the AMCCI?
A. Initial participation is 12 months. Members will have the opportunity to continue with the program after 12 months, if they choose to do so.
Q. How does the AMCCI work?
A. A case manager will be assigned to each participating member. You and your case manager will discuss your medical and other concerns, one-on-one, including your emergency room usage.
Additionally, your case manager will interact with your medical providers and perform a medical record review to better understand the care you have received. After gathering information from you and your providers, the case manager will work with you to develop a plan of care.
If you don’t already have one, your case manager will also assist you to obtain a primary care provider (doctor, nurse practitioner, or physician assistant), a hospital, a pharmacy, and if appropriate, a behavioral health provider who will work with the case manager and the member to manage their care. Your case manager will also assist you to obtain transportation, housing and other supports, as needed.
Your case manager will regularly be in contact with you to work as your advocate and helping to get the health care and support you need.
Q. Case Management Hours of Operation
A. Case management services will minimally be performed between 7:00 AM to 7:00 PM Monday through Friday, however your case manager will work with you to assure you are able to access their support and services. Check with your Case Manager for specific hours of operation.
Q. How do I sign-up for the AMCCI?
A. If you have not received a letter inviting you to participate in the AMCCI and would like to participate, you can access the member letter at http://dhss.alaska.gov/dhcs/Pages/amcci/. Please print and fill out the information on the form and fax or mail it to the address listed. Or you can call the Quality Assurance Unit to assist you. Please see the contact information the AMCCI website shown above.
Q. What happens if I DO NOT volunteer for the AMCCI?
A. Your participation in the AMCCI is NOT required. If you choose NOT to participate in the AMCCI, the number and type of services you have used will continue to be reviewed periodically and your use of Alaska Medicaid services may still be restricted if certain conditions are met under the Care Management Program which is adopted at Medicaid regulation 7 AAC 105.600.
Q. Where can I find more information about the Care Management Program, which is a different program than the AMCCI?
A. Go to the Xerox, the State’s fiscal agent, website to obtain a more information about the Care Management Program.
Q. How can I give feedback on my experience with the AMCCI?
A. On this website, the AMCCI website, there is a link to the Feedback form. Fill it out and either mail or fax it to us (addresses are shown on the form). You may contact us at any time (see the Contact List on this website). Additionally, during the time you participate in the AMCCI program, you will be given a patient participation survey to complete. Our goal is for the AMCCI program to be a positive experience for all participants.
Q. Can I refer someone to the AMCCI?
A. Anyone can make a referral to the AMCCI for members they think would benefit from case management services or other reasons. Just complete the “Member Referral” form available on the AMCCI website.
Q. Where should I go for healthcare?
A. For most medical problems, you should go to your regular health care provider first. You get the best care because they know you and your medical history. During regular office hours, call your doctor’s office.
If you’re unsure where to go for help, call your doctor first.
Q. How do I know if I have an emergency?
A. You should only use a hospital emergency room for very serious or life-threatening problems. An emergency is a sudden injury or illness that if not treated right away, could cause death or permanent harm. If you are pregnant, it could mean harm to you or your baby’s health.
Your case manager will provide education about emergency symptoms. If you are experiencing emergency symptoms, don’t wait! Call 911 or have yourself taken to the nearest hospital emergency room. Some examples of an emergency are:
- Broken bones
- Chest pains
- Difficulty breathing or shortness of breath
- Unconsciousness (black out)
- •Sudden dizziness, weakness, or loss of coordination or balance
- Numbness in the face, arm or leg
- Sudden blurred vision
- Convulsions or seizures
- Sudden severe headache (not a migraine)
- Sudden severe abdominal pain
- Severe burns
- Coughing or vomiting blood
- Deep cuts or bleeding that won’t stop
- High fevers
- Any vaginal bleeding during pregnancy
- Any other condition you believe is life threatening.