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Category Archives: medicaid

a new year, more medicaid frustration

So what else is new?  right? Received this notice from the facility where our son resides. I am sure you will be receiving a hard copy in the mail, but I wanted to notify you that as of 1/10/2015, David’s  Medicaid has denied coverage for residential care and we were notified of this yesterday. (See attached letter) Facility is currently in the process of appealing this decision. I will keep you notified of the results of the appeal process which will be submitted early next week.     They enclosed a copy of the notice that they received from the determination company that is under contract to our state Medicaid. The rationale for this decision is:  David is a 13 year old boy who is diagnosed with Bipolar disorder and pervasive development disorder.  He was in a residential setting in North Dakota for over a year and transferred to the

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Tags: ascend, autism, denial of services, discharge, Medicaid ·

Medicaid resolved

Just received notification that our Medicaid case for David has been resolved. That is a load off my mind.  Long story short, because we worked with our case manager to find placement, and got denials from 5 in-state facilities before we placed David in another state, he is still covered by our state Medicaid. What a relief. Now.  If the average parent didn’t know that they could fight decisions, how would they deal with this kind of case?  While my first thought was to fight it, I also had a pretty good idea of where to start the fight.  This isn’t the case for most parents.  I know quire a few that would just accept the decision and move on.  It doesn’t make them bad parents. How do we inform them? Tweet #fighting4answrs

Tags: advocacy, autism, education, Medicaid, prtf, resolved ·

Medicaid letter

As part of the process of dealing with Medicaid, we received a letter from our county social services office. It reads in part: Your Medicaid will end on May 31, 2014 because: Your case closed as you requested. It then goes on to list the applicable laws. Further it states: The Medicaid for David is closing as he is at the facility in Billings, MT.  A subadopt child is considered to be a resident of the state they are physically living in and will need to apply for Medicaid in the state where they are currently residing. My thoughts. David is 12 years old.  He can’t be emancipated to live on his own until he is like 16.   The only reason he is at this facility is because all of the facilities in the state we live in said that they couldn’t take him if the last facility he was

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Tags: Medicaid, prtf ·

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