Kinnick Kay and Carver Lee: December 25th, 2009

Friday, December 25, 2009

December 25th, 2009

We had a nice Christmas with all of the kids. Everyone was up early and ready to open gifts. I thought I would share some of the fun.

Wow, all of these are for me? Where should I begin?

Thank you Grandma Woolley for the yearly Hawkeye ornament.

Carver got a new hammer that makes noise and lights up when you bang it.

Rainbows has been lending us some really neat books. We have to return the books in March. So, with help from Grandpa Woolley and Pat, we were able to purchase 3 of the favorites - That's not my Bear, Something Special, and Geraldine's Blanket. Thank you Grandpa Woolley and Pat.

Kinnick and Carver will be 3 in March. You know what that means....Kinnick has no idea what kind of seat she is sitting on.

Carver got a new toy that we can push up to his big Bumbo seat. It has lots of lights and noises.

Kinnick got a new shopping cart - they start shopping young these days.

Big brother, Hayden wanted to show off his new WII game - Star Wars Clone Wars.

Big brother, Gage wanted to show off his new Ipod Nano.

Big brother, Harrison wanted to show off his new PSP. He got one last year for Christmas and someone stole it at school - bummer.

Big brother, Gregory loves trains and wanted to show off his new LEGO train.

Big sister, Kirsten is finishing her 2nd year of college. She applied to Dental Hygiene school and we are hoping she is accepted. 125 - 150 apply and only 40 are accepted each year. We got her a bigger book bag to carry all of her medical books.

All in all we had a very nice Christmas. Now we need to find room for all of new toys and gifts.

I hope everyone had a very wonderful Christmas!

2 comments:

Sherri said...: Aww...looks like the kids had a great Christmas! I LOVE their faces! Pure joy :)

You know Elise will be 3 the end of July. I am not holding my breath that she will potty trained by then. Right now, she knows what it is, but cries if I even attempt to get her close to it...haha....LOVE the new header pic! Your kids are supremely adorable! All 7 of them :); December 26, 2009 at 4:43 PM
Anonymous said...: So glad to see everyone together having a good time celebrating Christmas! Everyone looks great!
Love
Neva; December 27, 2009 at 5:11 PM

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Disability Determination when you don't qualify Financially

In order to extend Cobra medical coverage 11 months due to a Disabled member of the family, a Disability Determination Award letter is required. How do you secure a Disability Determination if you are not intitled to an Award? You ask for a Special Determination (SSA-553) of Disability. How did we get this? Here are my contacts:

We live in Wichita, KS. My contact at the Social Security Administration in Wichita was Nick Janzen. His phone number is 866-931-4486.

The Kansas/Nebraska/Iowa/Missouri Regional SSA office is located in Kansas City. My contact in the Kansas City Office is Mike Stiles. His phone number is 816-936-5740. Mike is able to communicate with all of the Disability Experts including those at the national headquarters in Baltimore, MD. Mike was able to guide my Wichita, KS contact, Nick in order to complete the necessary paperwork to obtain a Disability Determination even though we didn't qualify under Title II or Title XV1.

Here's is how it worked:

Nick completed a paper SSA-3820 (for a child), and obtained as much medical evidence as possible from me. He also prepared an SSA-5002 with the date of my qualiffying event (date I went on Cobra initially). This material was then sent to the following Address:

Office of Medical and Vocational Expertise

P.O. Box 17786

Baltimore, MD 21235-7786

A Manual Development Worksheet (MDW) was used to document my case.

The OMVE will prepare and release the appropriate notice for this type of case and will return the completed case to the field office along with a special determination (SSA-553) of disability and a copy of the notice.

Overnight address:

SSA, Office of Medical and Vocational Expertise

1st Floor Oak Meadows Building

6401 Security Blvd

Baltimore, MD 21235

Sedgwick County Developmental Disability Organization - MRDD Waiver information

Kinnick and Carver are on the MRDD Waiver. This is a needs based program based on being mentally retarded or developmentally delayed - not income. So, regardless of income, you may qualify. What benefit are we getting from the MRDD waiver? If you are on this program at age 5, you will receive a medicaid card. Prior to turning age 5 (while on the waiting list), you qualify for case management and family support funds. Case management is very helpful in helping you find funding sources if needed. The family support funds have provided all of K&C's expensive equipment needs. Due to budget cuts, the family support funds are not available this year, but could return at any time. You shouldn't wait to sign up for this program. There is a waiting list to receive the medicaid card at age 5. The waiting list is 2 years or longer. Therefore the sooner you get on the waiting list the better. You do not have to be 5 to be on the waiting list.

How do you apply for the MRDD Waiver program?

Rachel Ryan

Intake and Referral Coordinator (SCDDO)

615 N. Main

Wichita, KS 67203

(316)-660-7640

http://www.sedgwickcounty.org/cddo

Kansas Medicaid - Travel Expenses

I'm posting this to help others. It has been a struggle to get Medicaid to pay for our travel expenses. I have been able to get them to commit to paying $81.00/day hotel expense, $27.00/day for food, and .20/mile for mileage to/from.

The KEY is to call the number(s) below before you leave on the trip (unless it is an emergency).

1-800-285-4978 Option 2 (Out of State Prior Auth)
The doctor from the referring hospital/office and the doctor that you will be seeing will need to send paperwork for your approval. You can call this number to confirm this is getting done.

1-888-561-8747 x5002 (Meals and Lodging)
Let them know where you are going and how long you think you will be there. You will have to call every 2 wks to extend the time. They only approve 2 wks at a time.

1-888-240-6497 (Transportation)
Let them know where you are going and how long you think you will be there. You will have to call every 2 wks to extend the time. They only approve 2 wks at a time.

Medical Transportation Approval Process

In order to obtain approval for Medical Transport, the following steps were followed:

1.) Kinnick and Carver's primary physician (Pediatrician) wrote a "Letter of Medical Necessity". Below is a small sampling of the letter:

LETTER OF MEDICAL NECESSITY

Date:
Insurance Company:
RE: Kinnick and Carver
DOB:
Diagnosis: ROP, 23 wk gestation twins, severe chronic lung disease.

Attention Medical Director:

The letter requested approval for an air ambulance round trip flight for the specific eye surgery. It then listed medical reasons why Kinnick and Carver's medical needs meet criteria for air ambulance transport for their eye surgery. Their medical needs consisted of the following:

Continuous oxygen per nasal cannula
Continuous cardiac and respiratory monitoring
Feeding intolerance that requires gastrostomy feeds
Deep suctioning using a suction machine and catheter

Signed by the Primary Physician

2.) My Primary Physician faxed the Letter to Kinnick and Carver's Case Manager at my Insurance Company.

3.) Kinnick and Carver's Case Manager forwarded the Letter to the Medical Director for approval. This process only took a couple of days.

4.) Kinnick and Carver's Case Manager faxed the Approval to Air Ambulance and my Primary Physician.

Kinnick Kay and Carver Lee

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