Got the approval letter from Medi-Cal. One day later got the BIC card. Tried to contact our Medi-cal case manager Juliana Mendosa several times on Friday and Monday but all I got is the voice mail.
Updates:
Tues 7/25: Juliana returned my call; I told her about our current situation with William’s ABA services; and asked her if there’s a way to expedite the transfer of Medi-cal to CalOptima. She said yes and scheduled to meet with the personnel from reimbursement department tomorrow at 9 AM.
Wed 7/26 @9 AM: Juliana called and set up a 3 way meeting so that the personnel from reimbursement department can ask me questions. She only asked me 1 question “Have William been using ABA services?”
– With Medi-cal? I was not sure so I asked.
– Yes – She responded.
– No, our ABA services agency said that our case must be transferred to Cal-Optima first before then can doing anything.
– OK, I’ll expedite the case, you can check with Cal-Optima tomorrow to see if you’re in Cal-Optima network; It should be in their system tomorrow.
That’s it.
Thursday 7/27/2017: I called Cal-Optima (714 246 8500) to check if our case is in Cal-Optima system yet or not. After asking about our Medi-Cal number, name, DOB, they transferred me to another department because they said my son is disabled and that department would be able to assist us. I left a voice message with my name, phone number and Medical-Number.
2 hours later I got a phone call (Vietnamese speaker) , asking what I need help with. I told her that I’d like to select group United Care and add my son’s doctor in the plan. I also asked her what does it take to get approval for ABA services. She gave me the Behavorial Health department number to contact.
So I called the number (855 877 3885) asking about how to to obtain approval for ABA services; I told the lady that we already have the ABA Services agency so she tried to look up ABEST name but could not find it; I gave her Nhu’s last name and first name, she could not find it either. She asked if I know any of the therapist name so I told her Nhi’s name; but she wanted to know Nhi’s last name which I don’t know. She told me to call back when I have enough information. (She refused to look up by MIS number).
So I called Nhu from ABEST, asked her for Nhi’s last name. And then called the number again.
A different person answered the phone; and she said that they don’t work directly with parents; ABA agency must contact them!
I’ve been making quite a few phone calls for the last few days; I’m so frustrated! ABEST told me to call Cal-Optima and Cal-Optima told me that they don’t work with parents; I really have no idea what to do! Frustration!
So I called Nhu, told her exactly what Cal-Optima told me, gave her the phone number that I called earlier so that she could call them. She said “That’s weird”, that with all the self-referring clients that she has, the parents always have to talk to the Insurance providers first to get a case manager assigned before she can talk to them.
Half hour later Nhu called back; she said she was assigned a case manager and given the case manager’s email to contact. Hopefully the case manager will contact her soon.
What a relief! finally it’s going somewhere. But I’m truly tired; mentally and physically tired!
Monday July 31, 2017: Mrs. Nhu came to our house for consultation; she said she still has not heard anything from the case manager.
Late afternoon Monday 5:45 PM.