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Passion Driven
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1,689 Posts
Discussion Starter #1
OK I want to make this as short and sweet as possible:

My sister had a baby born with Cystic Hygroma (spelling?) - she has a cyst that keeps re-growing around her cheeks so she has a trache and a feeding tube.

So since she has a "special needs" child Medicaid pays for her to have Nurse visits once a week.

Low-and-behold, my wife's a nurse! So my wife worked 40hrs a week in 4 days at her other job, and then spent every Thursday with my niece and took care of her.



Now- since getting paid isn't very "simple" from medicaid and given she works 1 day a week with my niece- my wife waited a full 2 years before claiming and getting paid for it (we treated it like getting a tax return, for investments and savings). So yippee.

This past year (2008) she didn't claim until October/November because she stopped in September. So she makes the claim in october, it takes 1 month to receive the check- but we get a notice that she filled it out wrong. She asks what she did wrong, reminds medicaid she has a new address and name (Married to me :p) and yet a month later this second attempt still comes back wrong! Medicaid keeps changing authorization numbers and rules and all this red tape and hoops to jump through!

Flash forward to January now and my wife gets paid for HALF of what she claimed in 2008! So she asks what she did wrong for the second half and now medicaid says "It's too late to claim for last years' work"

WHAT?! Medicaid's lack of help and useful information and constant shifting around with numbers and authorization methods is what stunted us from getting paid last year! Plus, my wife collected 2006 AND 2007 in late Dec '07!


So now my blood's boiling. My wife was overworked for so long and DID the work and now Medicaid is saying it's OUR fault?! They couldn't even get her new last name and address right- they STILL sent notices of denied payments to her old address!

So we're wondering who to contact next. We're looking up some upper level individuals in medicaid and we're gonna see what happens...

/vent
 

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Premium Member
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4,002 Posts
This is the reason that most doctor's offices do not accept Medicaid. They will fuck with you so much until you are read to slash your own wrists. I have many patients that have Medicare and Medicaid. Medicare covers 80% and Medicaid is "supposed" to cover the other 20%. We tell them upfront that the patient is responsible for the 20%. I dont have fucking time to chase after medicaid.
 

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Passion Driven
Joined
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1,689 Posts
Discussion Starter #3
But there IS a worth in fighting for this, right? Just talk to a higher authority there to overrule this ridiculous situation...?
 

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i lift trucks
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1,204 Posts
I can't help you out with any words of wisdom.

I can however wish you and your wife luck in getting this taken care of. Dealing with them is the biggest headache of bullshit ever.
 

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Officer... he has dope!
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39 Posts
I would be able to enlighten a little bit on this information, but my knowledge is in Florida Medicaid. I hate NY for all their fucking stringent rules
 

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pirates like cookies
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702 Posts
Send your story to your senator, or governor, or media outlet?

With millions of people unemployed, yes, put a story on the news about somebody with a job, not getting paid for one day per week because they couldn't follow rules and fill out paperwork....


This story definitely has legs
 
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