Hello, my name is Christopher Lavin. I’m an attorney with the Lavin Law Group. We are an elder law firm here in Lebanon, Ohio.
This is my Medicaid case specialist, Christine Doss, and she’s been doing it for 20 years. Her job is to do the same thing that the case workers do for Ohio, but she’s looking at it from your perspective. And she’s always making sure that I’m on top of things because she knows just how time sensitive these cases are.
And if we wait around for three or four months because we’re busy, we’re looking at statutes or trying to get some additional information, you’re paying that fee to the facility, $10,000, $10,000, $10,000. It adds up very quickly, unfortunately, and that money doesn’t come back. So our job is to get the application.
We try to work on a 30-day cycle, which is difficult, but we try to get that going so we can get that application fired off. And what happens once we get that application fired off, Christine? When I fire off the application, I make sure that we’re resource eligible. At that time, I reach out to the nursing homes to let them know that we have a Medicaid application pending.
Oftentimes, they want a pending Medicaid number. I will give them that number. I will estimate our patient liability, the payment that I think that’s gonna be due, and I tell the family to pay that on a monthly basis while the Medicaid application is in a pending status.
And that’s extremely important because what we’ll tell the clients is that the family is that the $10,000 a month is actually on hold during the course of the application. We apply for Medicaid with the idea that Medicaid is gonna start paying the bill, but the audit takes, what, two or three months easier? Yes, two or three months. Some counties are faster than others, but… And two or three months on your side is nerve-wracking and on the facility side is nerve-wracking because everybody would like to be paid.
Everybody wants their payment, money in the bank, which I understand. And you have to deal with that often, don’t you? So I reach out to the business office managers. I try to keep them updated on the Medicaid status.
Which is important because everybody has someone to answer to. So they have a boss who’s wondering why this family’s 30, 40, 50,000 in arrears. And what we’ll tell the client is, please, and the facilities don’t do this often, but please don’t pay the facility and then expect getting paid back from Ohio because they’re not getting paid back, or I think that’s the case.
Absolutely not. But explain the importance of paying the income during that audit period. That keeps the nursing home at bay.
They’re satisfied because they know once the Medicaid application’s gonna be paid, then their bill is gonna be paid and that my money should be owed if the client is paying the patient liability on a monthly basis. And the patient liability is a fancy word for income. So that’s the one thing that we always have to chip in.
It’s a give and take. So we always have to at least chip in our income. So we have to give the facility that income during that application process.
And it’s a nerve-wracking process because the application, we call it the audit for a reason, and it can be delayed. But it is very time-sensitive. You wanna have advisors that are not new to the game.
They’ve done it for a long time. We’ve done it for 28 years as a firm, and it’s all we do as a firm. Because not knowing the laws and being on equal footing with Ohio can cost you dearly.
Oh, extremely, yes.