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Take care,
Carol
Please update us when you can.
Carol
True, but I can never remember where I put the danged source!
Dad died in the 1980's. Mom went into a NH & applied for Medicaid 2011 but still had coverage with Medicare & FEHB/BCBS. Once mom got ineligible for Medicaid, FEHB suspended. Her Blues required either suspension or cancellation once another carrier (medicaid) could pay. As Medicaid application took almost 6 mos, there were a whole host of providers & vendors who billed BCBS & got paid for services during that period in the NH and then they got a letter & clawback from BC months & months later. Now I did send a certified letter to NH as to the changes and rebilling. But as so much of getting providers (PT, OT, Podiatrist, etc) is done by facility as per orders of the NH medical director, I don't know who or what for. Add to this that providers get all sorts of payments & corrections & clawbacks from all insurers so stuff is confusing. Flash forward & mom gets bills from all kinds of vendors. I sent letters to then that they needed to rebill to medicaid. I assume all done. Well over a year later mom got bills from therapists who did not take Medicaid and have had a full clawback of $ paid by Blue. 1 was ok with being paid over time. The other was not, would not take payments, threatened collections, etc but actually out of luck as his agreement was with the facility. So if you do FEHB suspension or cancellation, make sure to do your best to find out that the NH has vendors that accept Medicaid as well as FEHB & the NH follows through on insurance changes with their vendors.
Also once they suspend FEHB, their income is increased,so their Medicaid required copay to the NH will increase by the same amount.