Tuesday, June 28, 2011

Doctors.


I don't know if every state is doing this, but the state I am in has taken the state insurance that every foster child has and put it in a blender and turned it on. When the blender is finished, you are randomly assigned some doctor that you have never heard of that might be 45 minutes from your house and that is who you take the kids to until you bug their DHS worker enough to get them switched back to their original doctor.

It has been tons of fun.

When the child first comes into care they have the normal "state" insurance, then depending on how fast the workers are, they are switched to a different insurance that is more of a private insurance. It still covers everything, but has a new name.

Back when Lizzy first moved in her worker messed everything up and basically she had insurance under her aunt's name through the state for a while. When the worker went back to fix it all he couldn't get it to go far enough back to cover her initial physical every child has to have when they first are put in foster care.

I HAVE HAD THIS BILL OPEN FOR OVER A YEAR. I called Lizzy's worker I loved so much and in her defense at one of the court hearings I did see her give a copy of the bill to the male DHS worker. He did nothing with it.

Months went by and I started harping on my agency to get it taken care of. They printed out some piece of paper that said that the insurance was retro active back to the date of the physical. My Dr. office tried billing them again and it was rejected.

My agency has been very unhelpful in getting this resolved. The original bill was for $150. So, after a year of these people not doing their job I took Lizzy back to the Dr. for her yearly physical today. I still owed the $150-or should I say the state still owed the $150.

At one point I had called the billing office and they said if I would pay it they would cut it in half. Today I took them up on it because I am sick of dealing with it. The best part is my agency told me that if I pay it DHS will not reimburse me. Isn't that nice. I was just sick of getting the bill and worrying about them throwing it on my credit so I paid it. I LOVE this Dr. and I am not going to ruin my relationship with him because I want my son to be able to go there IN GOOD STANDING.

In this post I haven't even told you about half the things I did to try to get these people to pay this bill. It really is ridiculous.

Have any of you had issues where the kids insurance wasn't working the way it was supposed to and caused you a head ache?

5 comments:

Denver Laura said...

Yup.

We have a pediatrician we LOVE. She takes Medicaid. When we have one placement leave, we wait to cancel the next appointment so when we get a new placement we can keep that spot open at the clinic. They have a limited number of patients they take on Medicaid.

When our kiddo was throwing up non-stop 3 days after we got him, we took him to urgent care. They said they could not take him. Even though there were other toddlers in the waiting room. They told us to go to the ER. So we did. The paperwork was a pain to fill out - they kept wanting MY SSN. I said nope, I'm not the legal guardian. After a while they finally figured out how to bypass that part of their system and we got a room.

They prescribed an anti-nausea pill and an antibiotic. The pharmacy filled the antibiotic but not the anti-nausea pills. It was $80 for 5 pills. We paid $50 for 3 out of pocket and are still waiting for reimbursement. I still think it's worth it not to have to clean puke out of my car (again).

CherubMamma said...

We're not having the "blender" problem. Thankfully! However, where I'm at in the country almost EVERY SINGLE INDIVIDUAL has Med.icaid. In fact, we have more problems explaining how our traditional insurance works (with my immediate family) to the hospitals because they aren't used to dealing with it. So, all my foster kids have come with a Med.icaid number already.

I must say though, no one explained to me how the insurance would change from "normal" to the alternative version for foster kids. That issue has been a pain in the neck for me because every single doctor takes Med.icaid down here. But not everyone takes the foster kid "Star" insurance.

I haven't had any billing issues myself. I'm glad I read enough blogs though to know not to include my SSN when I'm filling out forms. I did have one ER throw a hissy fit because I wouldn't sign anything saying I'm responsible if Med.icaid doesn't pay. But, they got over it when they realized they had to treat Pumpkin and I wasn't going to sign anything like that.

I detest the way the state insurance works in general. But, thankfully I haven't had any billing problems come back to haunt me.

:)De said...

I was just scheduling well child check ups for my two foster children and was told that their medicaid will no longer allow siblings to be seen on the same day. They must have seperate appointments on separate days. If families use public transportation, they would have to take the bus with all the kids on seperate days to get them all seen. Ridiculus!! And the only dentist that takes medicaid in this town... I would not let him clean my dogs teeth! I pay out of pocket take all the kids to the same dentist that I take my kids to.

Carol said...

Yup! Since we are in the same state we know exactly what you are talking about. There is a bill laying on the counter right now to give to the CW tomorrow for the umpteenth time tomorrow when she comes. It is for a 2 yr well chkup for a boy we had already had for 10 months. That one apt. was in the middle of the blender deal. The county has said a month ago after 5 mo of it not getting paid that they would pay it out of county funds. It is now 7 mo and the bills are still coming.

The CW worked at it until she got the insurance switched to the one our pediatrician takes.

Its part of the fun of the system. NOT!

Diane said...

We are told in training not to sign any papers indicating we will pay if insurance doesn't. I either line the statements out or sign "Diane for DES" (Dept. of Econ. Security who issues the insurance cards for foster children.