Category Archives: System Navigation

Need Help Filing For Disability?

From our Friends at Easterseals Disability Services,

Do you know someone who need help filing for disability?  We’re here to help!

Refer them to our six one-hour webinars covering the following topics

(1) The Basics of SSI and SSDI                         (4) The SSA Work History Report

(2) The SSA Forms 3368, 827 & 1696             (5) The SSA Adult Function Report

(3) The Medical Eligibility Criteria                 (6) Transition from Childhood to Adult Disability

Register and find out more at http://www.easterseals.com/co/our-programs/dbs/webinar-trainings.html or see attached flyer!  If you have any questions, please contact me at bkish@eastersealscolorado.org or 303-515-1653.

Writing a Letter of Medical Necessity

Writing a Letter of Medical Necessity

  1. Name of child, names of parents (parents and child may have different names)
  2. Date of birth of child
  3. Insurance plan name (there may be more than one plan)
  4. Relevant diagnoses (codes are helpful only if they are accurate!)
  5. Item/service requested
  6. Why item/service is medically necessary (refer to the plans’ definition)
  7. What positive/negative impacts the item/service will result on (include financial) scope and duration of treatment
  8. Supplemental documents (letters from other providers, research articles, product information, PAR)
  9. Include funding streams NOT able to help (denial letters help)

Terms to use; medically necessary, clinically based, promoting independence, preventing secondary disability, cost-effective, safety.

Terms to avoid; custodial, rehabilitate, developmental delay/disability, speech delay (without a diagnosis such as aphasia), Caregiver convenience.

  1. Ask if your Letter of Medical Necessity answers the following:
    • Is there a licensed provider stating in writing the item/service is medically necessary?
    • Is this item/service not for care giver convenience?
    • Is this item/service costs effective and if so have you explained how?
    • Is this item/service considered standard medical practice?
    • Have you explained how long and how often the item/service will be used.
    • Is this item/service right for the need of individual?

The Responsibilities of Each Role

Care provider needs to know the process if the parent is not yet skilled

    1. pertinent benefits
    2. limitations and exclusions
    3. appeals process
    4. terms and their definitions
    5. distribute instructive materials to parents (empowerment)
    6. write perfect letters of medical necessity

Parent needs to

    1. become knowledgeable about the policy (a-d above)
    2. supply information to providers
    3. keep a paper trail of all communications
    4. confront conflicting information

Advocate’s role is to

  1. assist with the appeals process
  2. guide providers and parents to resources
  3. influence systems’ change

Health insurance plan’s staff member

    1. confuse the member as much as possible (i.e., change the rules often), and deny benefits to contain costs.

 

 

Project Independence: A Great Opportunity for Denver Families.

Parents of teens with disabilities tend to be anxious about what will happen once high school ends. Project Independence is the answer.

Project Independence provides free workshops to help Denver parents who have children with disabilities learn about options for their children once they leave high school.  The project also trains youth from ages 14-21 about their options after high school.

A disability should not hamper a person to live their life to the fullest.  We share with participants how to obtainemployment in the community, assist in applying for college and vocational school, as well as support with life skills.  Statistics shows that people with disabilities earn about two-thirds of the median earnings of people without disabilities.  They are less likely to attend higher learning, and more likely to live below the poverty line.  Project Independence wants to change that.

There will be 2 strands of workshops: One for parents and one for youth.  It will be for 5 Tuesdays starting March 20th ending April 17th, and a college tour on Saturday, April 7th. The time of the workshops will be 6:00 – 6:30 for dinner, and 6:30 – 8:30 for training.

Attached is the registration form that you can complete and email back to at yvette@thrivectr.org or fax back at 303-923-3973.  You can also click this link http://www.thrivectr.org/new-events-1/ to register online.

FREQUENTLY ASKED QUESTIONS

Is there a cost?

No, there are no cost to families.

Do I and my child attend the workshops together?

Yes and No.  You both will come to the same location but after eating dinner, the parents will be in one room for their workshop and the youth will be in another room.

What if I don’t want to bring my child and I just want to come for the information, can I do that?

Yes, but we encourage that you bring your child.   However, we understand that in some circumstances that may not be possible.

Can I drop my child off and not attend the parent session?

No, your attendance is important so you can learn how to support what your child is learning at his/her sessions.

What will my child do at his/her sessions?

It will be interactive. They will not have to sit still and have someone talk at them. There will be activities to keep them engaged such as role play, games, engaging discussions, field trip to college, etc.

What will happen at the parent sessions?

Parents will be introduced to the many options that are available for their transitional youth, and will learn how to access those options.  College, employment, independence is possible.

What if my child is 18 years old or older?

They are welcome to come without their parents but you would have to register your child or your child register on his/her own.  They can call the office if they need assistance.

Do I have to come to all the sessions?

We do expect parents to commit to all the session.  However, we understand that circumstances can happen that you cannot control.  We don’t want you to miss out because you may have to miss one or two sessions. We understand that the timing of the workshop may interfere with spring break.

How do I sign up?

You can register at the THRIVE website at www.thrivectr.org. Click the tab Workshops/Events. Stroll down and click on line registration.  You can also call the office to register at 303-632-6840 or contact Katie to email you a registration form.

Please contact THRIVE if you have any questions or concerns at 303-632-6840 or email Katie at katie@thrivectr.org