Caregivers Story

Story

I just helped my mother, age 89, deal with her Medicare HMO. Her primary care doctor referred her to a specialist for a nerve conduction study to see if she was a candidate for carpal tunnel surgery. The office staff did not realize that they were required to get prior authorization for that procedure and the HMO denied coverage for the procedure.
My mother got a bill for over $2000. I helped her go through the grievance process to ensure she met the deadlines and used language that would help her case. I argued that the elderly do not fully understand all the fine print in their insurance contracts, and they rely on their primary care doctor to send in the proper forms and get care authorized for them. The HMO reversed its decision and paid the claim.

by: S.

QUESTIONS

  • My wife is permanatly disabled under social security disablity. Part of her disablitiy is problems with comprehension. Between her learning disablity and hearing impairment, she has a really hard time comunicating with doctors and insurance companies. She just can't comprehend these things. She wants me to be her Medical Power of Attorney so that she doesn't have to deal with insurance companies customer service. The only information I can find is related to seniors. Can you help us? Where to go.. who to see?
  • My mother had quad bypass surgery 10/07. Upon coming home from the hospital we needed a caregiver to help my mom take her meds go to the bathroom , feed herself , bathe herself etc. After 90 days my mothers LTC kicked in. We filed a claim with Humana , which is the provider that administers her medicare , on 04/20/07. We called a couple of weeks later and were told it takes 30 days to process. We then called the end of May and were told they have it but to wait another 30 days. We called at the end of June and were now told it was in the wrong dept but it would now be expedited. I called mid July spoke to a "manager " Joe Clark who said it was still in the worng dept but he wopuld expedite it and call me back in 1-2 days. NO CALL 10 days later I call and speak to Stephanie, and she tells me her sup. will call me back NO CALL. i call 5 days later speak to Woodley , he tells me he has no idea about the delay but will rush it. I call at the end of July speak to yet another manager who tells me they "changed" vendors and need me to refax the entire claim. She asks me what the claim is about I tell her and she tells me that what I described to her is really more "housekeeping" work and not covered. KEEP IN MIND she hasn't even reviewed the claim. I am now approaching 4 months since we first submitted this and I am at wits end. What are my options to get this expedited one way or another
  • My 91 year-old father has recently been admitted to an Altzheimer's long term care facility. My stepsister, his ex-wife and a fiduciary have healthcare Power of Attorney. The fiduciary is private and only acts as a substitute. I have no access to his medical records. I live in CA & cannot take charge of his care. He's medicated and sleepy all the time. How can I get access to his medical records without becoming responsible for his care from another state? My stepsister is not cooperative and has even threatened my visits with my father. The fiduciary interceded on my behalf. His ex-wife has taken all his assets.
  • I have an adult handicapped daughter who lives alone and has been put in hospital for emergency care several times for severely neglecting herself;refusing to eat or receive help or care from family. She is paralyzed with Spina Bifida, mentally ill, and suicidal. Presently in hospital for her neglect.I am her mother.She needs long term care but refuses/How can I do it legally?
  • I have been mostly supported by my spouse the last few years. After a heart attack, I am no longer able to work and trying to get on social security so I can eventually receive medicare. Social security told me that I have not worked enough quarters the last 15 years to qualify. What about all the years before that?
  • I recently moved to Arizona from Oregon. I tried to be seen by a local internist and was refused service without an explanation. I have no conditions which could make me a concern. I asked the office for their evaluation criteria and they would not provide it. If they are going to refuse service, they should at least state the grounds for doing so.
  • What is Medicare?
  • My mother is 85 and being treated by a naturopathic doctor. My sister and I are concerned that the care she is getting is harming her overall health. We have contacted the Naturopathic Physician Medical Board to file a complaint. They are willing to move forward and subpoena her medical records for review. The problem is that they say there is no way to keep this physician from mentioning it to our mother. We feel that our mother puts an abnormal amount of "faith" in this physician and that she has been, for lack of a better word, "brainwashed" into believing that he can do no harm. We want to proceed without fear that he will convince my mother that we are "the bad guys." What do we need to do to proceed without fear that he will discuss this with our mother? Any suggestions or guidance would be greatly appreciated.
  • My father-in-law just got approved for AHCCCS. He had originally signed up for Humana so wondering if he can still use the Humana?
  • Don't qualify for AHCCCS,to young for medicare, if there is a catastrophic health issue I do not want all my savings wiped out so where can this money be put where the debtors can not touch it. Trusts?Where can my money be protected?Financial help/applications will want to know all about your accounts and will take every dime you have. I have paid my bills in the past. This is just a hypothetical question in case of a major illness. I simply cannot afford health insurance beginning in 2019

STORIES

  • I just helped my mother, age 89, deal with her Medicare HMO. . .
  • Age discrimination in the workplace. . .
  • He told me that I could actually get all the money I needed by using my home as collateral. . .

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  • State Bar of Arizona
    www.azbar.org
  • Maricopa County Bar
    www.maricopabar.org
    Referral number 602-257-4434
  • Pima County Bar
    www.pimacountybar.org
    Referral number 520-623-4625
  • National Domestic Violence Hotline
    800-799-7233
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    866-553-0893
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