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User Info Hahahahaha (Spamazon's Bezos' Paper Lies); entered at 2018-04-16 12:54:05
Posts: 6877
Registered: 2008-05-19 Caution: Congress at Work
Oh, here's a good one for you - my ongoing experience going down the rabbit hole.

My daughter gets SSI and Medicaid. She's bona-fide intellectually disabled, but she's high functioning and holds down a part-time job in a fast food restaurant while she's finishing High School. She gets speech therapy every other week for 45 minutes or so. She gets some other, occasional, support services, but nothing that would be on a weekly basis - maybe a couple of times a month.

So, I'm finding out that, without permission or authorization, the school figured out her Medicaid information and started charging her Medicaid. Charges everyday - including days she's ****ING ABSENT. "Office Visits" of $40 a day, "Personal Care", you name it. A few grand.

Aside from the lack of authorization (and this being a HIPPA violation giving their sharing data for non-educational purposes) the fact they're charging left and right is another matter.

Now, get this. At least in TX, I can't log into a portal to check benefits. I caught this because TX Medicaid knew of my kid's private insurance and of course, is going to toss the claim to them, see what they pay - if anything - and then pay whatever. Now the thing is that even our private insurance didn't notify us of the EoB, because if nothing is 'owed' it is their policy to not sent a notification - Medicaid does the same thing. I caught it while I was doing some other reconciliation of a few bills and was 'What the **** is this?'

I ended up speaking to a few attorneys. EACH ONE said that the 'state' (the schools included) can't be sued and it's a pervasive thing that the state is even 'in on' in order to get more funding. They encourage the schools to charge whatever they can, for every day, because there's no way for anyone to check and it's RARE for a parent that has a kid on Medicaid to have private insurance and, like us, because there's no notification for zero patient liability, no EoB notification is generated.

One attorney mused that he suspected the reason why so many kids on Medicaid are placed in special needs (aside from the social-economic aspects) is that the kids have Medicaid that the schools can milk.

****ing awesome, isn't it?

Best part. You know all of those "Report Medicare/Medicaid Fraud" - meh they don't ****ing care. I have a case with full documentation and there's more hoops to jump through than a 10-ring circus.
2018-04-16 12:54:05