Kinnick Kay and Carver Lee: January 10th, 2008

Thursday, January 10, 2008

January 10th, 2008

Carver is going to be dismissed from the hospital tomorrow since he will not require any surgery at this time. The hospital has really tried to accommodate me. They offered to let Carver stay in his bed and use their oxygen. They even offered to lend me a small oximeter. However, this would tie me to the room. I would not be able to leave the room. I'm not sure how I would manage meals, showers, etc.... I only brought 4 pairs of clothes (since I have a washer/dryer at my hotel), so not sure how I would even wash clothes. The hospital staff could not care for him due to liability reasons. The insurance company won't allow him to stay since there is no need for him to be there. So, the hospital is going to get me oxygen and an oximeter - rentals. My other problems... I was only allowed 2 bags for both babies and myself combined. The plan was to keep the babies in the hospital till they went home, so all I have is a car seat. I don't even have a base for the car seat. I don't have a stroller, bed, formula, meds, or diapers. I have a couple of burp rags, and a couple of bottles. The head of the Peds floor said that she thinks she has a stroller in storage that she can lend me. So, tomorrow will be interesting. Right now, I'm sizing up the laundry basket in my hotel room - perhaps it will work for a bed ;O). Anyway, I'm sure we'll manage. God always seems to take care of us. As long as I have a stroller, oxygen, and an oximeter I think we'll do fine. I just hate the thought of hauling him all over the place and in/out of the peds floor.

2 comments:

Anonymous said...: Oh my goodness! You are a super woman to deal with all of this! It's good news that Carver's doing so well, but I can see how that brings another set of challenges! Let us know how it all goes. You're always on our hearts!
Love,
Neva; January 11, 2008 at 12:48 PM
Anonymous said...: While, I was writing to you, I saw a news slip about The ARC in Wichita. I guess they help special needs children and talked about helping with child care for parents. That's about all they said before they talked about a fundraiser luncheon. The number they gave was 316-943-1191. Thought it might be worth a try. I've left a message for our old neighbors, but haven't heard back yet. Talk to you more soon,
Neva; January 11, 2008 at 12:53 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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