Thursday, November 28, 2013

Medicaid Migraine

Here's the goose chase we've been on over the last six months:

June 10-We mailed the completed application for Medicaid (for myself and Jackson).  Even though I had Blue Cross Blue Shield through the end of maternity leave, I wanted to get us approved and in the system. The theory was that we could simply add the names of the children once they were born and it would go into effect ASAP. 

July 15-Happy birthday James, Amelia, and Madeline!

July 19-Babies had their first appointment with the pediatrician for weight checks.  Because they weren't expected to have insurance as newborns, the receptionist assumed they'd be added to my insurance. 

Late July-We still hadn't heard from Medicaid.  FYI, the phone system is ridiculous and there is no option to leave a voicemail.  Jesse went to DSS office, only to be told they never received our application.

August 1-Babies had two week check up with pediatrician.  Maddie was back up to birth weight and all three were healthy.  We were told we didn't need to schedule another appointment until two months old.

August 15-I receive a call from a social worker through the hospital.  She informed us that insurance claims must be made within 45 days of birth.  We only had two weeks from that phone call to make sure everything was processed. 

Late August-I spent every morning on the phone with hospital social workers, DSS, and case managers to try and check on the status of our Medicaid.

August 30-Medicaid cards were issued for all four children (with one day to spare).  Praise God!

September 18-We took babies to the pediatrician for their two month well-check (which included four immunizations per child).  The receptionist told us we would either need to pay upfront (almost $700) or reschedule because our Primary Care Physician was incorrect.  They would not accept our insurance until the PCP listed their provider number.

Mid September to Early October-I tried to call the customer service number dozens of times.  You have to listen to about 10 minutes of automated prompts and menus before being directed to the actual Medicaid office.  Again, there is no voicemail so if you don't get through you hear, "We're sorry.  We are currently assisting another client.  Please try again." before you are automatically disconnected.

October 16-Maddie and I went to DSS after her chiropractor appointment.  We waited in line for over an hour and finally got to talk to a kind social worker.  She inputed the correct information into the system and assured me the change would be updated within 7-10 business days.

November 5-We still had not received updated insurance cards.  After dropping Jackson off at preschool, the babies and I waited in line for almost two hours at DSS.  Another social worker looked up our information, confirmed that the PCP had been changed, but informed me that insurance cards were never issued to be mailed.  She requested that the cards be mailed and told me to call (what a joke!) if I didn't receive them within a week.

November 10-When we came back from the beach, we found four new insurance cards in the mail!  Unfortunately, they STILL had the wrong PCP listed!!!

November 12-After dropping Jackson off at preschool, the babies and I went to the pediatrician's office to try to resolve the issue.  The receptionist informed me that they cannot accept our insurance until their provider number is listed.  I happened to glance up and see a letter on the glass door that announced our beloved pediatrician had left the practice.  We still cannot schedule an appointment until our insurance cards are correct.  I was given a list of pediatricians in the area to contact.

Mid-November-I called all local pediatrics offices, only to be told that they are not accepting new Medicaid patients.  I continued to call DSS, only to be disconnected after sitting through the automated prompts.

November 27-Since Jesse had the day off, I was able to go to DSS by myself this time.  The line was rather short, and the social worker assured me that even though their electronic system was down, I would leave with an answer today.  I was given a number and directed towards another waiting area.  When my number was finally called, I went back to speak to a case worker directly.  Here was our conversation:
(I swear I'm not making this up!)

CW: How can I help you today?
Me: I need to update the PCP on my insurance cards.
CW: Did they not tell you that the system is down?
Me: Yes, but I...
CW (interrupted): Yet you chose to wait anyway?  What did you think I could do?
Me: Well, I've been up here four times before and...
CW (interrupted again): Oh, you don't have to explain.  I've heard it all.
I received a text, which caused my phone to vibrate in my purse.
CW: What is that?  Is that your phone?  My God that's annoying.  Turn that off.
Me: Okay.  So what am I supposed to do about the PCP?
CW: Well you can fill out the change of request form and I'll enter it in the system on Monday.  (Hands me the form.)
Me:  But I've already done that multiple times.
CW (rolls eyes): So you don't want me to change your PCP?  That's why you came in here.
Me: I just want to know what the problem is.  I've received new insurance cards but they still have...
CW (interrupted AGAIN): Right.  Well, the only other thing I can do is give you your personal case manager's phone number.
Me: Will that be a direct number?
CW: Yes.  We're closed until Monday.
Me: Fine.

At least I have something new to try on Monday.  The babies have not seen a doctor or had any immunizations in the last four months.  I feel angry and helpless, but I cannot afford the thousands of dollars in medical expenses.   

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