Frequently asked Questions
From Case Managers and Service Providers
What is the advantage of referring my client to Providence ElderPlace?
Providence ElderPlace is able to provide your client with highly integrated, holistic case management services. The entire Providence ElderPlace team of health and social service professionals acts together as one case management entity. Together the team develops the individualized care plan for each client and has the resources to oversee and carry out the plan of care.
Who is the most appropriate client to refer to Providence ElderPlace?
The PACE model of long-term care is designed to serve older adults who are living in the community who functionally meet the COPES level of care as determined by a social worker from Department of Social and Health Services.
If my clients join Providence ElderPlace, do they need to attend the day health program?
No. Participation in the Day Health program is optional. Upon enrollment, the Providence ElderPlace team of health and social service professionals will designate a regular attendance schedule for your clients. However, clients have the option of canceling their attendance if they are medically stable. Clients will need to come to the Providence ElderPlace center for medical care and possibly for other services. Regular attendance upon initial enrollment is highly encouraged, since the Providence ElderPlace team needs to get to know your clients to provide good care.
Does Providence ElderPlace ever accept clients younger than 55?
No. The age limit is mandated by federal regulations.
What if my clients do not want to change their primary care provider?
People who enroll in our program are asked to change their primary care provider to one of the Providence ElderPlace primary care providers. We understand that changing your doctor might be a difficult decision. The benefit to our participants is that our primary care providers have a lighter case load which often gives them more time to listen. They are able to get to know their patients very well in a shorter period of time and truly understand each patient's individual needs
What happens if my client joins ElderPlace and doesn’t like it?
Providence ElderPlace is a program of choice. Participants who are unhappy with our services have the option of leaving the program and returning to their former services and providers. Medicaid participants who wish to leave ElderPlace sign a disenrollment form, which is submitted to Home & Community Services. The ElderPlace Social Worker is available to assist with discharge planning.
How does funding work at Providence ElderPlace?
ElderPlace receives a capitated amount of money from the state (for clients with Medicaid) and federal government (for clients who have Medicare) Individuals who are not financially eligible for Medicaid but meet other eligibility criteria may choose to pay privately. Please call the Intake Representative for further information.
Why does your daily rate seem so high?
Not only is this rate lower than the average nursing home rate in King county, it also includes medical costs. This rate covers all primary and specialty care, prescribed medications, personal care costs (in-home or in residential settings), hospitalizations, and nursing home stays. Unlike the traditional fee-for-service model, Providence ElderPlace is able to use this money to authorize any services that are necessary to stabilize and enhance participant’s quality of life.
What happens if my clients are currently enrolled with another insurance plan?
Your clients will need to disenroll from their current insurance plan to enroll with Providence ElderPlace. The ElderPlace Intake Representative can assist you with this process and coordinate the timing to ensure there is no gap in your client's service and coverage.
For Medicaid clients: Does Providence ElderPlace pay Individual Providers (IP’s)?
Yes. ElderPlace can pay IPs at the state rate. However, ElderPlace cannot guarantee that an IP who previously worked on an hourly basis for COPES clients will retain the same number of work hours. IPs must undergo a criminal background check and sign a contract with Providence ElderPlace. Like all services provided to participants, the IP is paid out of the Providence ElderPlace capitated rate.