I had Mom approved for Medicaid. June 9th she was admitted to a skilled nursing facility. The told us at the admission meeting that she had been approved under Medicaid. When I called to confirm this, the billing department said that they were waiting for the state to send them what her portion of the bill would be so that I could pay that and then they would bill medicaid. Why would they send the bill for the 6th through the 30th of JUne and prebill for July at the full rate? When they receive the spendown account from medicaid will the adjust the billing? The current statement is for over $9000.00 for the June days and the month of July. Anyone I should call? Would it be better to Department of Health and Human services. FYI we are in Illinois
If indeed, this is the self pay rate (that would put it at about $5000 per month? My mom, who is private pay, is $15,000/month) it's most likely a billing error and easily rectified. If not, remember, this is your mother's bill, not yours.
If she is pending, you need to look at the admissions contract to see just how this facility states they can do the billing at till she is fully eligible and approved.
Do you have your mom's awards letters….by that I mean the letters from SSA and from her retirement or any other monthly income? For SS & civil service/federal, they come in Nov/Dec and state what they will get paid starting Jan of the new year. The awards letters are basically what the state Medicaid program uses to determine mom's co-pay or "SOC" (share of cost) required to be paid to the NH less whatever your state has as the personal needs allowance (this runs from $ 105 - $ 35 a mo). Like for my mom she got $ 900 a mo SS less her Medicare payment (abt $ 104) so roughly $ 800 a mo SS plus a retirement of 1K, her personal allowance was $ 60 (TX), so every mo her SOC was $ 1,740 that had to be paid to the NH. I wrote a check for it from her bank account and let the account build by the $ 60 personal allowance each month.
If you did the paperwork for your mom's Medicaid application, the awards letters were probably a part of the documents required. I'd copy them and do a brief note with a check from mom's bank account for exactly whatever the co-pay/SOC (less the personal needs allowance) is and send all to the NH. If your gut feeling is that the facility biz office is incompetent, send it certified mail with the return registered receipt from USPO - runs about $ 8.00.
Have you done a trust account @ the NH for mom? The trust account is for incidentals like beauty shoppe, the canteen (if the NH does one) or to pay for their phone or cable if the NH has a fee for that. WHat seems to happen is that the NH presses upon family to have all their monthly income go directly to the facility and then the facility places their allowance in the residents trust account. But you do NOT have to do this despite whatever the NH says…….
If you should ever decide to move mom to another NH, having them get her monthly income will be a beast to get changed & deal with.
Tax assessor notice of next year appraisal / April (45 days to file appeal by 6/1)
Tax assessor bill for next year / Oct (due Jan)
Civil service / federal retirement notice of next year monthly payment / Nov
SS notice of next year monthly income / Dec (I think this comes later as SS can get a COLA last minute)
Civil service / federal /SS income paid for past year taxes (w-2) / Jan
Dividends, interest for past years / Jan
Annual Medicaid renewal was about 90 days before her initial eligibility month & due back to TxDADS / HHS 14 days from date of letter and every year was either postmarked days after letter date so received past due date or right on due date or a day before. This same thing (consumer loss of days to respond) is also happening with MERP letters.