Guest guest Posted April 5, 2005 Report Share Posted April 5, 2005 Joni, I have many "case managers" from the teacher to the special ed director and then mh/mr and that case manager and used to have a wrap around case manager.. help at home and school, and the social lady called herself that also.. etc...However.. think the doc and you are also case managers. But have never found a case manager over all.. just piecemeal. Sort of think that it is just a job placement within eaah category. Kathy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 5, 2005 Report Share Posted April 5, 2005 oh and yes Joni the insurance companies also.. ultimaterly u are the case manager as Mom.. I hope.. Kathy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 5, 2005 Report Share Posted April 5, 2005 Hi everyone, What is a case manager? Are they through the insurance company or a social service agency? It would be wonderful to have someone helping us figure things out as we are swamped with bills, changing insurance, networks, yada yada yada, you all know what I'm talking about. How do we get some help in this area? Thanks everyone! Take care, Joni Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 5, 2005 Report Share Posted April 5, 2005 Hi Joni :-) Case Managers are through the insurance company. Ideally, they are "in-house" although sometimes they are with a seperate company the insurance company contracts with. I know some have not ended up with ones that have been all that helpful, but for many the case managers are invaluable and really can help make insurance issues easier to get through. Ours, while not in-house unfortunatly, has been instrumental in getting several things covered that were being denied, with my help. If your on an HMO, you may need your PCP to call and request a case manager, but can generally make the call yourself if your on a PPO. Just call the main number and let them know that your needing one and they should be able to direct you in the right direction. Once we explained our situation to the case management division, they had one set up for us ASAP. Hope this helps!! -- BIG hugs, Kass, proud mom to Chance(11-Mito), Madison(8-Mito), and Abby(7-Mito) "Life is not measured by the breaths we take, but by the moments that take our breath away" Unknown loerco333 wrote: Hi everyone, What is a case manager? Are they through the insurance company or a social service agency? It would be wonderful to have someone helping us figure things out as we are swamped with bills, changing insurance, networks, yada yada yada, you all know what I'm talking about. How do we get some help in this area? Thanks everyone! Take care, Joni Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 5, 2005 Report Share Posted April 5, 2005 We have several case workers and what they do really depends on where they work. It sounds like you are referring to case workers in insurance companies and we do have one of them. For us, our case worker has been a true blessing! She has been able to get meds and other things covered that sometimes would never have a chance to be covered. She knows our situation and so when new bills go to the insurance company, she isn't surprised and there isn't a fight as to whether the insurance company will pay or not. We have been able to get more therapies approved, meds usually not covered, breast pump rental for a time period, etc. Any time we have a question about a bill being covered, we call her and she usually can handle the problem or get back to us to be able to help us in whatever we are dealing with. There are also case workers in waiver programs. We have one for Asenath. She is on the brain injury waiver (Zipporrah is on a waiting list). She helps organize Asenath's treatment plans, helps get things covered like wheelchairs, ramps, etc., organizes nursing care needs, etc. Lastly, we also have social workers that are known as case workers through the Department of Human Services. Because we are foster parents and adoptive parents we deal with them regularly. They can also be very helpful to receive help caring for our kids. They can be very informative in how you can get services provided such as waivers, nursing care, etc. Hope this helps you some. See www.caringbridge.org/ia/mitomomof9 and www.heartbeatsformito.org (a photo look into Mito) Darla: mommy to Asenath (5) Mito, CNS Vasculitis, strokes, migraines, seizures, G-tube, hypotonicity, disautonomia, SID, global delays, cyclic vomiting, bladder issues, some wheelchair use, eye issues, gastric emptying issues... Zipporrah (17 months) Mito, strokes, neuro-motor planning, SID, GERD, dysphasia, G-tube fed, speech delays, extreme fatigue, aberrant subclavian artery, disautonomia, hypertonicity, migraines, possible seizures, dumping syndrome, iron deficiency... Luke (17)migraines, sensory issues, & some evidence of SLE's... Leah (14), Rachael (13), Isaac (11), Tirzah (8), Kezia (4), Marquis (3) Joey (15 months) with hydrocephalus, dysgenesis of the corpus callosum, encephalomalacia & leukomalacia, G-tube, GERD, immobile, severe dev. delays, left hemiplegia (arm)... (15 months) SID, dev. delays, right hemiparesis issues... What is a case manager? > > > Hi everyone, > What is a case manager? Are they through the insurance company > or a social service agency? It would be wonderful to have someone > helping us figure things out as we are swamped with bills, changing > insurance, networks, yada yada yada, you all know what I'm talking > about. How do we get some help in this area? Thanks everyone! Take > care, Joni > > > > > > > Please contact mito-owner with any problems or questions. > Quote Link to comment Share on other sites More sharing options...
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