Medicaid Waiver: Prior to Waiver, 1 page of paperwork Obtained Services; Post Waiver, 17+ pages of paperwork Keeps the LME Busy and Eats up the Medicaid Money
This is a tragic miscarriage of public mental health. There are 17 pages to be filled out and mailed to WHN LME in order that my Medicaid (only; no Medicare) client receive services. Said client has a hx of severe sexual abuse and has a diagnosis of Dissociative Identity Disorder. Said client was raped by step-father for 7 years. Said client uses crack when dissociating. Said client has been arrested 3 x over past 10 yrs re: dissociation. Said client attempts to work and is a gentle-natured person w/ a spouse and 2 children living in ann RV park due to lack of funds.
There's a part of me that is determined to reveal this scam for what it is.....regardless of the cost to me in terms of paperwork and irritation and frustration.
There is no reason why public monies should be employed to create and support this kind of system, these LME's which are consuming most of the Medicaid money pushing all this paper around.
GIVE US A ONE PAYER SYSTEM, PLEASE SIR:
This is from the WHN LME page which is only part of creating a file for a Medicaid client to be followed by an Out of Network Provider.
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http://www.westernhighlands.org/service-authorization-procedures.html#registration
To Activate a Case
Managed Sessions, Enhanced Services
PRTF (Psychiatric Residential Treatment Facility)
TFC (Therapeutic Foster Care)
Form 1: ERF - Enrolee Registration Form (4/3/12)
ERF Instructions | ERF (English) | ERF (Spanish)
If you have a CCIS log-in, fax to 828-225-2797 to complete documents electronically.
Form 2: STR - Screening, Triage, and Referral Form if not completed by WHN in the last 60 days
Note: DCCI must also be completed with paper submission.
Form 3: DCCI - Description of Consumer’s Clinical Issues (updated 4/13/12)
Form 4: LCAD - LME Consumer Admission and Discharge Form
To Request Services
You will need to Activate the Case and submit the following forms:
Form 5: TAR (Treatment Plan) - Treatment Authorization Request (TAR)
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