Tuesday, February 24, 2009

Verbal or Paper, Ma'am? PAPER PLEASE!

So, we don't have a surgery date yet.

Yesterday I spent most of the day checking our home phone voicemail, since our phone has an attitude and decides when it wants to work and when it doesn't. NOT good when you are expecting important phone calls.

I got lucky and receive a call from our CI insurance gal in the morning. She had gotten a message (Friday) from a supervisor at Medicaid stating that AJ's case had been approved, "Even though you didn't send in the corrections for the denial, that's ok." Nice. That's because she never got it! Moving on...

Our CI insurance gal attempted to contact this supervisor directly, with no luck. She then spent 2 1/2 hours ON HOLD with Provider Services and never got a hold of a human. We are unsure as to whether or not his case was assigned a new PA#, which is what she was inquiring about. In addition, she had not received anything on PAPER stating his case was approved, just a verbal approval. Anyone care to guess how they send out the approval letters? That's right, to Froedtert Hospital, with JUST INITIALS. You win the prize!(If only there was a price is right wheel to spin and win some dough everytime we guess their procedures-we'd be millionaires). She did state that we are going to move forward, as she was already informing our audiologist of the approval and the surgery scheduler. Yeah!

Hmmmm. With all that has happened, should we just take their word for it? I'll let you all answer that on your own. :)

We received a call from someone at Medicaid on Saturday. She left a voicemail (of course we didn't get it till today with our stupid phone issues). She stated she was from these Bureau of Product Integrity and wanted to verify that we were approved, that our provider had been notified via phone on late Friday, and that if we had any further questions or concerns to contact her directly. She also stated that they were taking our concerns and the issues we had with the Member Services Line seriously.

Yesterday, I called the legislative liasion and left a message, informing her of our current status (no paper approval), my concern and our CI insurance gal's concern regarding that, etc. I also called the person from the Bureau of Program Intergrity. Left a similiar message to what I left for the liasion.

I did not hear from the surgery scheduler yesterday. Bummer. Everyone seemed to be out of the office yesterday, so maybe she was too.

This morning I received a call from the legislative liasion. We had a very nice and productive conversation. She understood my concern for the missing "paper approval" and was glad to hear that I had followed up with the B of Prog. Int. person. She promised to follow-up again on her end and get a PAPER approval to our CI insurance gal. I had given her our CI insurance gal's direct number. The liasion was sure that with the new computer system, the approval should be available in the portal (electronically online). You'd think. We are really hoping that our CI insurance gal shares with the liasion how many cases she has sitting waiting for approvals. We hope that our experience and determination to gain approval for AJ will help other kiddos that are coming up in the process behind him.

Hopefully today, I'll hear from the surgery scheduler. I'll keep everyone posted!

1 comment:

  1. I have a daughter (age 4) from Haiti that has severe CP and bilateral cochlear implants. I would LOVE to talk more with you!

    Kelly

    ReplyDelete

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