Re: managed care conversion update

[Guest guest]

Hi all,

I just got off the phone with from Aetna (whom I promptly called when

Ellen posted her number on this listserve) So far they have managed to either

sign on or get single case agreements for all but 2 of Quentin's providers (the

most important one for us being the neurologist specialised in epilepsy at

Children's)

Nonetheless, I was told that Quentin could continue to see any provider until

December 31 as long as they are medicaid approved.

Also got approval for his meds which are not on their approved list. The nurse

at Children's told me that Aetna answered their request for approval within 24

hours and that their patients that have Illinicare either didn't get responses

or were not approved.

Thais

PS anyone going to center tomorrow that can fill me in? I'm going to

try to do the webinar but I think my computer is too outdated

[Guest guest]

Thais, thanks for sharing your experiences with Aetna Better Health (Managed

Care Div. of Aetna)...I was amazed that they were able to get a single case

agreement for us for our psychiatrist. His stipulation was that we come in more

often...I always avoided going more because it was so

expensive...so...win-win...Noah gets seen more and has a little better care

(hopefully) and the Doc will probably make up the difference in reimbursement by

seeing Noah a little more frequently. They are still working on Noah's

internist. We also worked with positive resolution,through a medication issue,

when one of Noah's meds dropped off the formulary.

Any more Managed/Integrated Care stories?

Ellen

Ellen Garber Bronfeld

egskb@...

[Guest guest]

Meant to mention...if anyone does go to the HFS Care Coordination Innovations

Project meeting at the Center this morning, please share info and

impressions with the group. I am not able to attend.

Thanks.

Ellen

Ellen Garber Bronfeld

egskb@...