About Kyla Kelim Expertise I can answer Medicare and Medicaid questions on a federal level but many state specific requirements would not permit more than a general answer for many specific questions regarding health insurance issues.
Experience I have practiced law in Florida and Alabama for 15 years. My firm has over 60 years collective experience in elder law issues, including Medicare, Medicare D, Medi-gap and related health insurance issues as well as nursing home Medicaid eligibility.
Organizations Alabama State Bar
Florida State Bar
Education/Credentials Cumberland School of Law, Samford University, J.D. 1993
University of New Orleans, B.S. Business Administration 1990
Question I work for a longterm care facility, I have recently been asked by a Medicaid HMO company to have a subscriber sign a Medicaid notification of non-coverage letter. I told them that I have never heard of this, I am familiar with Medicare denial letters but non Medicaid HMO denial letters. I was told to use a facility generated denial letter, we don not have one. I do not know what to even include in this letter. Have you ever heard or seen one of these letters they are referring to?
Answer Ms. Stevens, I do not typically answer these questions. Its my opinion, in this and other areas where a large business, with multiple issues of law and regulation are concerned, that you absolutely need your own lawyer and/or other source of coverage assistance. This case is no different. This is a site to the Center for Medicare and Medicare Services' (CMS) generic letter, however, I encourage you to seek counsel immediately so you will know what information to put in it. Your beneficiaries need to know the appeal rights of the QIO, as the appeal time is only 3 days in some cases, and the appeal must be faxed. Here it is, but DON'T stop here: http://www.cms.hhs.gov/BNI/Downloads/CMS10095a.pdf ,
