How to avoid a mess

[tanner]

Long story short in January we took in 2 month old twin boys and are going through the adoption process. At the time they were covered by Medicaid and not being our children yet they stayed covered by Medicaid. When they were 5 months old one of them started having spasms / seizures and regressed in his development. He has been in and out of the hospital but on July 3rd he was admitted to the hospital and has had several surgeries he is still there today. He had a trach put in today and is currently in ICU. He is progressing and should turn out just fine.

 

However, Medicaid is fighting some of the charges and hospital stays. They are looking at days between surgeries and not wanting to pay for them. At no time in this has he been in a stable enough condition to be released. My question is are we going to be hit with a huge bill we will never be able to pay? Does the hospital appeal this stuff? Does anyone know how this works?

 

Edit: The hospital has not said anything about it we have just been getting denial letters from Medicaid.

Edited September 30, 2009 by tanner

[Why Chat]

Long story short in January we took in 2 month old twin boys and are going through the adoption process. At the time they were covered by Medicaid and not being our children yet they stayed covered by Medicaid. When they were 5 months old one of them started having spasms / seizures and regressed in his development. He has been in and out of the hospital but on July 3rd he was admitted to the hospital and has had several surgeries he is still there today. He had a trach put in today and is currently in ICU. He is progressing and should turn out just fine.

 

However, Medicaid is fighting some of the charges and hospital stays. They are looking at days between surgeries and not wanting to pay for them. At no time in this has he been in a stable enough condition to be released. My question is are we going to be hit with a huge bill we will never be able to pay? Does the hospital appeal this stuff? Does anyone know how this works?

 

Edit: The hospital has not said anything about it we have just been getting denial letters from Medicaid.

Congratulations on your wonderful labor of love.

 

I suggest you contact your State's Medicaid supervisory agency and request an immediate review of all the problems. If you can't get any satisfaction from them contact the case worker for your adoption process and request assistance.

[tanner]

Thank you. We are going through a private Attorney for the adoption so there is no case worker. When you call the Medicaid number listed on the letters you get into an endless loop of menus that go no where until finally a recording gives you a number to call (the same number with the endless menus).

 

My Wife is going to talk to Hospital Admin today I think a letter from a couple of Dr.s stating his condition during those dates might clear it up.

[Why Chat]

Thank you. We are going through a private Attorney for the adoption so there is no case worker. When you call the Medicaid number listed on the letters you get into an endless loop of menus that go no where until finally a recording gives you a number to call (the same number with the endless menus).

 

My Wife is going to talk to Hospital Admin today I think a letter from a couple of Dr.s stating his condition during those dates might clear it up.

Do not call the # on the letters, look for help here;

http://www.cms.hhs.gov/HealthCareConInit/

[tanner]

Thanks Why Chat my Wife spoke with someone today and assured her that since he is covered we will never be personally responsible for a medical bill. They and the Hospital will work it out. We have never used any form of Government assistance but I thank God it was available for him or we would be bankrupt.

 

Just a side note one of his meds is $35,000 a vial and that is good for 5 shots. He was getting one a day until they figured it was doing more harm than good. The prescription was for 6 vials at a time (210,000) They have now taken him off the medicine and we have 4 vials in our fridge (140,000) so I ask the Dr what do I do with this expensive medicine, hoping I can donate it to a family that cannot afford it or private ins does not cover 100%. Turns out I cannot legally donate it but was told it is great to water into our house plants

[Why Chat]

Thanks Why Chat my Wife spoke with someone today and assured her that since he is covered we will never be personally responsible for a medical bill. They and the Hospital will work it out. We have never used any form of Government assistance but I thank God it was available for him or we would be bankrupt.

 

Just a side note one of his meds is $35,000 a vial and that is good for 5 shots. He was getting one a day until they figured it was doing more harm than good. The prescription was for 6 vials at a time (210,000) They have now taken him off the medicine and we have 4 vials in our fridge (140,000) so I ask the Dr what do I do with this expensive medicine, hoping I can donate it to a family that cannot afford it or private ins does not cover 100%. Turns out I cannot legally donate it but was told it is great to water into our house plants

I seldom would disagree with a doctor's advice, but in THIS CASE I would strongly urge you to call someone in your community who can give you better advice on disposing of what might be dangerous to dispose of in your garbage or even sewer system. If you have pets in the house or a toddler, DO NOT water any plants with anything that might get into the plant's leaves.

 

As to the "assurance" your wife obtained from "someone"-- Beaurocracy is the best system for fouling things up, and the Medicaid system takes top prize of all the systems. Get an official WRITTEN document from someone in AUTHORITY.

 

BTW- Even Medicaid has a co-pay for most cases for prescriptions and medical services.