I have been in contact with a director from Ascend Management Innovations regarding the different denial letters we received regarding David’s care.
Actually, I should qualify that. They read my blog, and then contacted me through voicemail and a comment on the blog post directly.
According to the director I spoke with, a very pleasant lady who directly engaged me in conversation regarding this issue. I forwarded an email copy of both denial letters to her. She is going to look into what happened. She did indicate that this is NOT standard practice for their company.
She also indicated that she only sees one denial letter.
So now we wait.
I am in the process of requesting a desk audit/appeal of the decision. we have another 15 days to get that letter in to their desk review person.
In addition, we are developing a team approach to David. Adding services as recommended (services that we have already tried) and ensuring that the therapists are properly documenting their notes regarding David’s care.
Getting Ascend to change their mind regarding David’s placement won’t get the bed back that we lost, but it should help get him authorization in a new facility once such a facility can be identified. Our goal is to keep David as close to home as possible. Sadly, the more time that passes, the further I feel he is going to be from home.