Navigating Healthcare: North Country's Hospital has a Dedicated Team of 'Navigators' that Help Patients Access Vital Services, Resources, and Financial Options

At North Country Hospital there is a team committed to helping individuals and families access essential healthcare resources and navigate the world of health insurance so that they do not miss out on resources and financial options open to them. This team is known as the "Navigators" Denise Bergeron, Patient Access Manager, took some time to explain what it is Navigators do, how they can help, and why they are such an important resource in the community.

Bergeron has been with the hospital for 22 years, and most of that time has been spent with this team. She said that they were once called financial counselors, and then with the introduction of the Vermont Health Connect program they began helping patients with more insurance enrollments and now, they are a very busy team.

Guiding Hands for Healthcare Enrollment One of the primary services offered by this team is guiding individuals through the complexities of healthcare enrollment. Patients turn to the Navigators' for help in obtaining insurance through the Vermont Health Connect, as well as enrolling in Medicare, Medicaid, or other health services.

They help during open enrollment periods, such as the upcoming open enrollment for MVP and Blue Cross Blue Shield of Vermont that begins on November 1. The Navigator team is well-versed in the upcoming changes for 2024 regarding Vermont Health Connect plans. Their extensive knowledge ensures that patients receive the most up-to-date information to make informed decisions about their healthcare.

They also help patients that come into the hospital, only to find out they do not have insurance, apply. Bergeron said that this is a more common issue right now. She explained that many people qualified for Medicaid during the Pandemic, and those services continued for a while following the official 'end' of the crisis. But, they have ended, and many people do not realize that they are no longer insured until they come into the emergency room.

The Navigators are busy helping patients in this situation as other programs, put into place for people that were kicked off of Medicaid following the pandemic programs came to an end, are also nearing their deadlines -so there isn't much time for patients to take advantage of them.

They also work with patients to identity other insurances and programs they qualify for -such as secondary or prescription insurances. For example, someone may have Medicare, but can also qualify for Medicaid as a secondary insurance to help cover more costs. Or, a child may be on a parent's work insurance, but the family may qualify for state insurance as a secondary to cover more of the out of pocket costs.

Beyond Basics: Comprehensive Support For those facing financial constraints, the team also provides invaluable advice on accessing various forms of financial assistance.

"We don't want to send people to collections ever, so we do everything we can to help them," Bergeron said.

She explained that there are often financial assistance programs, payment plans, and discounts that are available to patients depending on their situations. The Navigators help walk patients through these options and apply for them.

And that isn't just for NCH, she said that they help people that have outstanding bills at neighboring hospitals such as UVM and Dartmouth. She said that the Navigators have access to those hospital's financial program forms and they help local people with applying for those programs as well.

The team's assistance goes beyond health insurance and financial aid.

They help patients apply for vital programs like 3Squares and fuel assistance. They address questions related to copays, coinsurance, and billing, ensuring patients have a clear understanding of their financial responsibilities and what they were charged for.

Bergeron also explained that with new people moving to the area, including immigrants from other countries, the Navigators are available to help with the various questions and concerns that these new residents have when it comes to Vermont's health insurance. Especially in regards to immigrants, Bergeron explained that the Navigators also work with the UVM extension to find additional programs as needed.

Small Businesses and Healthcare Access Recognizing the gaps in healthcare coverage, the team has expanded its services to support small businesses that do not offer health benefits. Bergeron said that the Navigators have set up times to go into those businesses to assist in enrolling eligible employees into Vermont healthcare programs, ensuring that even those working for businesses without insurance options can access the care they need.

In a time where access to healthcare is more critical than ever, the team at North Country Hospital stands as a beacon of support, providing not only enrollment services but also financial guidance, education, and advocacy for their community. With decades of experience and a genuine dedication to their patients, the Navigator program at NCH plays an indispensable role in ensuring healthcare access for the greater Orleans County Community