Proxy Coverage Day: A Case Study

* Baby social worker visited. Plan is to initiate care proceedings ASAP reasons; history of substance misuse, concealed pregnancy, poor engagement with treatment and services

SC placed call to Pa’s CG and friend Teresa Lim and for monitoring phone call because none of the numbers on file for Pa was in working order. She reported that the Pa is doing well and is taking a break from radiation and chemo. She Provided the SC with Pa’s new phone numbers. SC asked about Pa’s service and Teresa reported that the Pa is receiving her PAS service specified in her care plan. Teresa reported that the Pa is happy with her current service and do wish to make any changes right now. The Pa is satisfied with her services and feels they are meeting her needs. No falls, hospitalizations, changes in health status or medications were reported. The SC end call with Teresa and place call to Pa via language line interpreter Michelle. The

With this request, I’m uncomfortable providing direct client information to you. As Co-Owner of Reliance Medical Management and our B2B relationship, we feel that it is our job to help you determine whether our offerings are the right ones for your specific needs. We do not burden our clients into selling our services for us, and we allow them to refer us as an option on their own time. We highly respect the value of their privacy and time, just as we will do with you and your pediatric office.

2. Guides, customer records, and work force documents will keep on being requested into courts in light of the fact that the legitimate framework believes the documentation contains data expected to settle on choices about youngster care, automatic hospitalization, and a wide cluster of different circumstances, including assertions of deceptive conduct. Absence of trustworthiness and ineptitude and in addition lost, fragmented, and insufficient graphs can be hurtful to the client and the counselor.

SC received a telephone call on 10/16/2015 stared 9:34 and end at 9:41 am from Tricia Crooks at Liberty Resources Home Choices (LRHC) Community Outreach and Enrollment Leader. Stating that she spoke Pa and he wants to resume his service order with LRHC for PAS service. SC informed SC that this information will first need to verify with Pa. SC expressed concerns about LRHC being able to fulfill service since they had the case unstaffed for over two weeks (09/25/15-10/15/2015). Tricia apologized on behalf of LRHC, and stated that they have someone assigned and is ready to go all is needed is the resumed service order ASAP. SC again explained to Tricia that Pa has to confirm this besides Pa was very adamant about switching provider because the

Meanwhile, the applicant’s attorney has recently designated Dr. Steven Mamigonian, a chiropractor, as a new primary treating physician. Per our discussion, Dr. Mamigonian is not within our Medical Provider Network. I have also issued an objection to applicant’s attorney’s office regarding the MPN issues.

which care is delivered by a specified network of providers who agree to comply with the care

I specified a close relative as my Health Care Agent. This was the most important legal issue I handled. As for the rest, I simply indicated which treatments I wanted them to proceed with and when to stop those treatments. That is legal in the State of Maryland, so I don’t believe there are other legal issues to consider in that regard.

I am writing in response to Nicoleta Shamah’s inquiry to the Illinois Department of Insurance dated September 1, 2016. In the inquiry, Mrs. Shamah requested a network waiver for her son, Nasser Shamah, to see Dr. Marisa Klein-Gitelman.

Additionally, when interviewed, Ms. Daniel stated that at the time that the parties were negotiating the recruitment agreements, the Practice and Hospital did have an oral agreement with respect to Dr. Shakfeh’s existing patients. However, Ms. Daniel said the oral agreement was solely that Dr. Shakfeh would not be required to report income derived from the recruited physicians’ services to those patients of the Practice who were already pregnant and had seen Dr. Shakfeh prior to the time Dr. Gomez and Dr. Tabbaa joined the Practice. Ms. Daniel also stated that these “established patients” did not include patients who started coming to the Practice after Dr. Gomez and Dr. Tabbaa commenced their practice, regardless of whether Dr. Shakfeh had seen the patient in the past for a different pregnancy. There are other contemporaneous internal e-mails related to the alleged oral agreement in which Ms. Daniel and Mr. Shafer attempt to explain their understanding of this alleged agreement. However, it is undisputed that the alleged oral agreement was not incorporated into the recruitment agreements.

According to ("Health care proxies - Medicare Interactive", 2016) a health care proxy is a health document that lets a patient chose an agent or proxy who makes decision on behalf of the patient.Situtation like these arise when a patient is not in a position to express his/her wishes. If the patient gains the ability to speak, he/she can change preferences. Health care proxy assumes the patient is incapacitated hence requires a proxy. However the patient has the right to periodically go through the health care proxy document in order to assess decisions made by the agent. Health care proxy allows a patient to name a second person who can act as your back up agent. In case one is not in a position to choose an agent, most states let close family

SC, Jennifer Stoker met face to face with Christopher for his Annual PDP meeting at his Day Hab in Dallas, TX.S SC was welcomed into the home by caregiver staff, Joel. SC observed Christopher siting in his wheelchair. He was awake and very alert. He was in a good mood and relaxed. He looked clean and comfortable. His provider, Rose Msewe, and SC Christian Gray Hering was present. Rose renewed his IPC during the meeting. SC discussed his HCS Rights and Consents with him. The following forms were explain to Christopher but he was unable to sign them: Authorization to Disclose Information, Verification of Receipt of Rights, Verification of IPC Services Request, Consent For Services, Your Rights in Local Authority Services Handbook, Your Rights

However, the Wraparound facilitator assigned to the case has to sign the application for the waiver. The facilitator did not feel comfortable signing the waiver, as she felt it was falsifying Lucy’s score and violating CEICMH’s policy for the CAFAS assessment. Without the signature of the Wraparound facilitator, Lucy’s SEDW was

SC meets with SCS to discuss issues highlighted in previous note on 1/14/2016 at 1:30 PM. SC asked SCS to explain how and why EDC are able to bill for a full day of servicer after 4.5 hours. SCS informed SC that that each Wavier service has its own policy and that 4.5 hrs at a day care is considers base on guidelines set forth by Wavier. SC thanks SCS for the explanation and moved on the next issue which was the installation for ERS. SC informed SCS that the provider reported that the service was done in October, 2015 but SC is only being allowed to add service for further dates. SC informed SCS that SC created the service order for the month of February. SCS was able to back date to November, 2015. SC called the provider and informed Tanya

After reading over the material in chapter 14, it is my opinion that selective contracting should not be allowed to exist between providers and payers. Utilizing selective contracting puts both the payer and the provider in a position to possibly limit the quality of care actually needed by the patient for their own benefit. This benefit doesn’t necessarily have to be in the form of a financial gain, but could merely be in the form of a financial security. Selective contracting appears to place of great deal of power within the hands of the payer, who now has the power to control fees charged by providers, through controlling which providers make it on their list of in plan providers.