Friday, February 20, 2009

Please hold, your call is important to us....

Translation: Please hold, while we take 40+ minutes to come up with some b.s. round about way of telling you we don't know what we're doing, what's going on with your son's case, and no, you can't talk to anyone else because your not a provider.

I waited until Thursday to call Medicaid back to see if they had received the correction with "which ear" OR our resubmission.

They've received neither. In addition, they now show the original claim being received on 1/29/09. Um, NO. It was faxed, three times, 11/7/08. Confirmation was received for each fax...to make sure they received it. No, I'm sorry Ma'am, it says 1/29/09. Where did it go from 11/08 to 1/09? I firmly asked to speak to a supervisor. I was told that Member Services (the dept to which I was speaking to) only has limited information and Provider Services has the details.

Guess what? I'm not a provider...so I can't speak to anyone in provider services. Poor guy, I don't think he intended for a nice stay-at-home mom to turn into Demando-Mom and start demanding information. Instead of saying something, he mostly said nothing. Only AJ's surgeon or his staff can speak to Provider Services.

Today, I geared up for another "on hold" session while doing dishes and prepping dinner for tonight. I love speakerphone. This round I spoke to a very nice, pleasant gal who was honest and gave me the same information. However, she did put me into the Ombudsman's voicemail, who of course, was gone for the day. Shortly after leaving a very detailed message for the Ombudsman, I called our CI Program insurance gal again.

She did not receive the paperwork back from Medicaid yet. She did not resubmit us as she had said she would on Friday. I did find out that we were faxed again on 1/29/09. Hm.... What happened to the original three faxed in 11/08? The Medicaid Monster ate them I guess. So this where the 1/29/09 is making sense now. We were refaxed again, with proper form, on 2/6/09...but they are still waiting for the returned paperwork Medicaid sent to them 2/4. The wonderful computer system shows his case as "pending". She said she'd work on it after she returned this afternoon and would call me Monday for sure.

I wrote to our representatives, contacted the journalist who wrote the articles on Medicaid's new computer system in the Journal Sentinel, and contacted a local new station who does special investigations.

I'll leave the rest of our info for another post...

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