anyone else on medicaid?
 

My broken vertebra is wedged into my spinal cord, we won't know how bad it is until they do the mri on the 24th. In the meantime, i am supposed to get this brace that has to be custom fitted to prevent it from moving any further... BUT the only company in the area that makes the darn thing is telling me medicaid will not cover it because i am over 21... even with the medical necessity paperwork form ortho. Ortho nurse says that is incorrect and they will be happy to submit the paperwork to medicaid... but I have to get in touch with my case worker to see where they need to send it.... I have been trying to call this woman since friday... 6 messages left and no return phone call. I left a message on the general mailbox voicemail, still no return call... What do i do now??

Getting in the car and going down there is not an option.

I would think the doctor would have a fax number to send it to.
Call the doctor back and ask.

For medications, we called the computer service for medicaid and they did the authorizations by phone. Don't know how devices would be handled. Maybe by phone too.

Monday was a holiday, so she may have had the day off. but...


Call the 1-800 number for medicaid. it should be listed on your card. Ask them whom to call.

Call the local hospital that treated you. Ask for the patient advocate. Ask them who to call.

Call the billing office of the hospital where you were treated. Ask them who to call.

Keep rattling cages. Please, dont take no for an answer. A broken back is cheaper to treat than a spinal cord injury.

Government agencies are so hard to deal with. You have to go through umpteen people just to be told the first person you spoke with was really the correct one. :rolleyes:

I often wonder what I'd do if I had a medical emergency. I have no medical insurance and Medicare won't take effect until August of this year. :confused:

I hope they can get you taken care of quickly. A broken back isn't just a boo-boo. I'd keep a diary of who I called, date, time and results. And how long it took for them to give you an answer. At some point they have to be held accountable.

When dealing with Medicaid my advice is to be the squeaky wheel so you get the oil. I have spent hours and hours trying to get a hold of people at the our State's medicaid office. UGH!

Call and ask to talk to a supervisor, manager, department head, or any other title you can think of. You may be passed around a bit but eventually you end up with a good worker who is truly willing to help you out and will too. Make sure you get that person's name and follow up with a letter commending them on their service. (Been there/done that and she always was willing to help me out after that.:p).

Whoever prescribed the brace should be the one submitting the paperwork to Medicaid for approval. Call the prescriber and talk to them about it faxing it to Medicaid for approval. Remind them that for continuity of care and prevention of serious complications due to your back they do have a responsibility to do what they can to get you that back brace and need to document all they have done to assist you. It is kind of like pulling the legal card on them but more than likely, you'll get approved rather quickly.

Call the company that makes the brace - the ones who are saying Medicaid won't cover it, which is ridiculous - and tell them you want to speak to a supervisor and keep moving up in rank documenting everyone you talked to. Again, as with the prescriber's office, this company does have a legal and moral responsibility for continuity of care. If they are smart, they will get the job done and not blow you off like that.

In the meantime, I do hope you feel better soon. Should you feel anything usual between now and then call your dr or go back to the ER.:hug::hug:

I'm an idiot!

I say this because the very nice lady from the fire dept (the one we got the puppy from) works for the main DSS office that oversees my local office. I just emailed her the whole story to see if she can get on them.

I also called back and left a message for the ortho nurse to call me about it, spoke to the prosthetics co, waiting for a call back from them.... Now that I finally recieved my card (45 days after being approved) and have the 800 # there is no reason for them not to be able to submit the info from the ortho office....

Hopefully i will have an answer this afternoon.

It just annoys me, kind of like how medicaid will cover the neverending supply of percocet but will not cover the NSAID. Makes no sense to me at all!

LOL. Here they will cover NSAID's and generic Tylenol but wouldn't cover Provigil as it is an amphetamine-like stimulant. LOL Guess they ASSume all of us on Medicaid are addicts so we can't get anything addictive. When I tried Provigil, I got samples from my neuro's office. There was another medication they wanted me to try, can't remember the name, but Medicaid wouldn't approve that one either. I don't know if they would cover percocet here as I haven't had a prescription for it but I am sure they would give some heck before it got filled. LOL

I hope the puppy lady can help you out and that the ortho's office gives you a call back today. :hug::hug:

i have never had any problems getting any pain killer or muscle relaxer approved for any insurance co. i had a harder time getting my antibiotic filled last time. This is the world we live. you can have all the pain killers you want to get addicted to but we will not allow you to take the anti-inflammatory that actually helps stop the pain from starting.

HA HA Go fire dept! I received an email right after i sent mine asking who my worker was. Low and behold 5 minutes later the case worker called me back! Go figure. We got almost everything straight they need the ortho office to fax over the prescription for the brace and a medical necessity form and then it should be covered no questions asked. Hoping it will be taken care of this afternoon and I will be able to go get fitted tomorrow!

man what a pain.

Way to go, Legz!!!! That is awesome and I hope everything goes smoothly for you from this point on.:hug: