[Design] Add Medicare claim number to 10-10EZ

[Dene-human]

Product Folder for Medicare Claim Number

Requested by HEC team on 11/23/2021. Add the Medicare Claim number as section 6C. after the effective date. The Enrollment System already has a section ready to accept the data as you will see from the next screen shot.

Acceptance criteria

• [x] Medicare claim number field is added to 10-10EZ after the effective date question
• [x] Error handling design for claim number field is included
• [ ] Finalize content

[Dene-human]

Medicare Remittance Advice

[Dene-human]

Hey @nicko-amida You probably already saw this, but just wanted to link it here: Transition hub-Features-Medicare claim number

[nicko-amida]

@Dene-human here's the medicare claim number design. One question though: was this supposed to be on its own page as its own distinct question? I thought it made sense to include it on the same page right after the effective date.

[Dene-human]

Cool. Yeah i think it makes sense for it to appear on the same page as the effective date. This page is only shown if user selects "yes" to the previous question that asks if they have medicare.

The only other thing to consider is error state. Do we want to validate with 11 characters? If so, we need to draft an error message.

[hdjustice]

FYI - Here is the Medicare Claim number folder in GH where we can store documentation, images, and anything else we need. I also added the sketch file link to the Readme doc for now.

[nicko-amida]

@Dene-human @hdjustice A few new updates:

• The claim number field now has an expandable info alert
• The open expandable info
• The closed and open error states.

[Dene-human]

Cool! Couple questions:

1. Did you already work with a content person on this?
   • A couple of things I'm thinking about
     1. I think we should be consistent with the Insurance detail page
     2. Label could be " Why we ask this information?"
     3. inner content could be inspired by (needs to be rewritten in plain language): "VA uses the claim number to create an Explanation of Benefits, known as Medicare Remittance Advice, outlining what Medicare would have paid VA if Medicare would not prohibited by law from paying for health care services provided by the VA to eligible Veterans. The MRA is used by VA to create a secondary bill to those carriers that require an EOB from Medicare prior to making payment."
     4. Then the hint text under label could be (needs Danielle to polish): Your Medicare claim numbers is 11 characters and can be found on the front of your Medicare card. (hint text example)
     5. Error message could be (needs Danielle to polish): "Your Medicare claim must consist of 11 characters made up of only numbers and uppercase letters"

Some reasons behind my thinking:

• Consistency with the rest of the insurance section
• I worry that providing an example number is actually confusing
• With error we want to give user guidance on a solution

Feel free to disagree with the above, we can talk through it and figure it out. Will you be able to bring this to our weekly content meeting with Danielle?

[nicko-amida]

@Dene-human Nope, no content input yet, but that all makes sense to me. I would want something more specific than "Why we ask this information" though, unless there's a need for that context. Something similar to the "What's my policy number" label on the insurance design would be my preferred labeling.

I can definitely bring this to Danielle!

[Dene-human]

Yeah I hear you on that. Ok let's talk through it with Danielle. As a rule when we add/edit a question we are trying to add a "Why we ask this information" component to most. But we can think through and balance that with user's need to find where/what the number is.

If you don't mind, you can come to the weekly content meeting with a couple of different mockup variations?

[nicko-amida]

@Dene-human Sure, will do.

[nicko-amida]

@DanielleThierryUSDSVA Here's what we can use to run by Tarsha:

Original: "VA uses the claim number to create an Explanation of Benefits, known as Medicare Remittance Advice, outlining what Medicare would have paid VA if Medicare would not prohibited by law from paying for health care services provided by the VA to eligible Veterans. The MRA is used by VA to create a secondary bill to those carriers that require an EOB from Medicare prior to making payment."

Draft plain language: The VA uses your Medicare claim number to notify health care providers that the VA is covering the health care costs that Medicare normally would.

[DanielleThierryUSDSVA]

Hi @nicko-amida. Let's ask Tarsha to review this Medicare explanation for accuracy. I don't think the language above is quite accurate, as I believe it's not that VA is covering the costs Medicare normally would, but that VA is billing the other insurance provider the person may have. But we'll definitely need an accuracy check on this. We can let her know that we also consulted this live page for reference on how we talk about Medicare and other insurance. Let me know if you have questions, and let me know if you'd like me to talk with Tarsha or if you'd like to. Thanks!

Why we ask for this information

We use your claim number when we need to create a Medicare explanation of benefits.

We don't bill Medicare for any services. By law, Medicare can't pay for our services. But this explanation shows what Medicare would have paid for services if they could. It's also called a Medicare remittance advice (or MRA).

We may need to bill Medicare supplemental insurance or a private insurance provider for certain services. And some providers must have this explanation before they'll pay the bill.

Note: Having Medicare or other health insurance doesn’t affect the VA health care benefits you can get. And you won’t have to pay any unpaid balance that a health insurance provider doesn't cover.

[nicko-amida]

@DanielleThierryUSDSVA Awesome, thank you!

[nicko-amida]

@DanielleThierryUSDSVA Here's a simplified version of your content I'd like to propose for our meeting tomorrow:

"We don't bill Medicare for any services, but this explanation shows what Medicare would have paid for services if they could. Some providers must have this explanation before they'll pay the bill.

Having Medicare or other health insurance doesn’t affect the VA health care benefits you can get. And you won’t have to pay any unpaid balance that a health insurance provider doesn't cover."

[DanielleThierryUSDSVA]

Hi @nicko-amida. I want to make sure it's clear why we can't shorten to the proposed content above, so I'm adding the info from our DM:

• The goal of this content is to explain why we need their claim number. But this shorter version cuts out the sentence about the claim number so we lose the whole context for the "why."
• We can't refer to "this explanation" without first naming the explanation or there's no context for what we mean by "this explanation."
• This version cuts out the fact that Medicare can't pay for VA services by law. So the phrase "if they could" has no context and doesn't make sense.
• This version cuts out the explanation that while we don't bill Medicare, we do sometimes have to bill Medical supplemental insurance or private insurance. Without that, the sentences of "Some providers must have this explanation before they'll pay the bill" and "you won't have to pay any unpaid balance that a health insurance provider doesn't cover" no longer makes sense because we don't explain that sometimes there's a bill involved.

One sentence I do think we could cut from the original is the one about the explanation also being called an "MRA." I was on the fence about that sentence anyway, and left it in for now. I think in this context, we can cut.

[nicko-amida]

@DanielleThierryUSDSVA Thanks!

[hdjustice]

Adding this information here for historical purposes to reference if needed. Per a Slack message from Dene', she confirmed with Joshua that the Medicare Claim number is supported. We will be sure to test end 2 end.

Dené Gabaldón I had to talk to Josh about something else so I went ahead and asked about this too. Here’s what he said: Medicare is entered under insurance and already supports a policy number Medicare claim number is supported in the model; we have never tested it with this service though; i ‘think’ it should work fine though. I told him that one of our engineers would coordinate with him to test before we push to prod

[hdjustice]

@nicko-amida - Can you provide the latest content here? Patrick is asking to confirm that we will still hit the recommended language from HEC with our plain language. Thanks!

[nicko-amida]

@hdjustice Yep, Danielle's content is mostly the same from above. I recommend we move forward with this content:

Why we ask for this information

We use your claim number when we need to create a Medicare explanation of benefits.

We don't bill Medicare for any services. By law, Medicare can't pay for our services. But this explanation shows what Medicare would have paid for services if they could.

We may need to bill Medicare supplemental insurance or a private insurance provider for certain services. And some providers must have this explanation before they'll pay the bill.

Note: Having Medicare or other health insurance doesn’t affect the VA health care benefits you can get. And you won’t have to pay any unpaid balance that a health insurance provider doesn't cover.

[hdjustice]

Thanks Nick! I just cc'd you on an email response to Patrick.

[markfallows]

@nicko-amida Can this be closed out?

[nicko-amida]

@markfallows Oh - yes!