Medi-Cal System Is Not Updated

Posted on by MICHELLE N

Tues 1/3/2018

For the past month we could not get medication for William; when we came to the pharmacy, their system shows Williams has active coverage with Anthem BlueCross thus they cannot use Medi-cal.  The billing lady at the doctor office told us the same thing.

I was so surprised because we requested to remove William out of Tim’s policy few months back when we got Medi-cal.  So I had Tim to talk to his HR again.  Not sure if they did not do it that time or it just took that long to be effective.  Finally it shows up as in-active at Anthem web site on Dec, with the Ended Date is 11/1/2017.

I thought the Medi-cal system would update automatically so I gave it 2 weeks to come to the pharmacy again; and guess what? The status is still active!

So I called Cal-Optima, they said I have to send in the Termination Letter from Anthem before they can TEMPORARILY REMOVE William’s insurance so that I can get medication for William; but this is just temporary.  To PERMANENTLY remove insurance, we need to contact Social Service.

So I called Ms. Juliana from Medi-Cal office; she was our Medi-cal case manager.   She said that we no longer have a specific case worker, we need call the Medi-cal number.

So I called the Medi-Cal number Ms. Juliana provided (waiting time was 1 hour, I left the phone number and they called back).  The lady temporarily remove William’s insurance so that we can get medication for William but she said that we still need to send in the termination letter from Anthem so that it can be permanently removed.  She said the system gets updated by the State so she has no control over it.  She removed it temporarily but the state will put it back unless it’s permanently updated by the state.

Later in the evening, I asked the pharmacy, and they said the system is still not updated!

Thursday 1/4/2018

8:10 AM We called Anthem requesting the termination letter.   It took about 20 minutes, finally I got the letter sent to me via email.  It’s a 2 step authentication process to open the pdf file: From the email, clicking on the link to register (name, email, password, etc. ) then it’d load the pdf file after account is created.  When opening the file it’d ask for password, which is given to me by the Anthem rep.  It’s Anthem1234.

12:00 PM I came to Staples to fax the termination letter to Cal Optima and Medical.  I tried both fax numbers given to me by the lady at the Medi-cal but they all failed.  So I went to Medi-cal website to get a fax number and faxed to that.  I also faxed to CalOptima.

Friday 1/5/2018

10 AM I called CalOptima, it took 15 minutes for the rep to find our fax; then she said she temporarily update the system so that William can get his medication.

12:00 PM I came to the Social Security office because no-one from Medi-cal office returned my call.  The front desk said for this I need to see a case worker; so I waited for 1 hour and 10 minutes to see one.  His name is Alex.  He checked the system and said that the system  was still not updated! I was so disappointed because I just talked to CalOptima 2 hours ago, and she assured me that it was temporarily updated.  At this point, I really felt that I can’t trust what people say anymore.

Alex said he would email Sacramento and once they receive the email, they’d process it within 24 hours, which means by Tuesday the system should be updated.  He also said he’d try to see if he can temporarily remove the insurance; he’d call me in 30 minutes to let me know.

So I went back to work; Half hour later Alex called and said that he was able to remove BlueCross insurance temporarily.

Monday 1/8/2018

A case worker returned my call!  She confirmed that BlueCross doesn’t show up in the state system anymore.  I called CalOptima to confirm, Molly said the same thing.

Tues 1/9/2018

So I asked our pharmacist  to check, he still could not bill Medi-cal!

5:00 PM.  I called CalOptima, talked to Molly again; and she still said the same thing.  William’s record only shows United Care Group which is the group that I selected from Cal-Optima.

So at this point I really don’t know what else to do.  Everyone from Medi-cal and CalOptima said there’s no private insurance in William record but the pharmacist still cannot bill Medi-cal; which means I still cannot get medication for my son.  Unbelievable!

The pharmacist suggested that we call United Care Group.

Fri 2/2/2018

I called Cal-Optima, they confirmed that the BlueCross Health Insurance is no longer listed in the system.  I’m so happy that this is finally taken care of.

Love Playing With The Sand

Posted on by MICHELLE N
William and the sand box

Wed 8:30 AM; William went straight to the sand box right after I dropped him off.   Everyone says he loves to play with the sand.  He used the Lego block that he took from home to scoop up the sand.  At some point he almost lied on the sand; now the sand is all over his jacket & pants.  (He always takes 1 thing with him to school but never brings it back)

I was about to leave when I saw this boy Zackerie tried to take the Lego away from William’s hand.  William refused to give it, so Zackerie kicked the sand toward William.   Mrs. Rose Mary & Nancy were there but they didn’t see that scene.  I waved my hand and approached William.  Mrs. Nancy saw me waving so she came to me and asking what’s wrong.  I told her what just happened. She said “Don’t worry, I’ll keep an eye on him”; and turned to Zackerie who was still hanging around the sand box, “This is William’s mom; Be nice to your friend, ok?”

I heard stories from Ms. Annie, Han & Celestie about some kids at this day care are not nice to William.  Some twins don’t want to share, they block the slide so that William can’t use it.   And Dominique always picks on William.  This is the first time that I saw it with my own eyes.

This is a small environment and William doesn’t fit it well, how can he survive in Kinder Garden, which will be next year because he’s 4 now? As a Mom I’m feel worried and sad.

First Day Back to Day Care After Holidays Break

Posted on by MICHELLE N

Morning Day 2 of the New Year, 2018; I have to work so I took William to Children World Preschool (Mitchell school is still on break until Jan 8, 2018 so William will spend his time at the day care full day this whole week).

Menu for this week, today lunch is served with Beans & Bacon with sandwich, I don’t think William would want to eat.

ABEST still have not received the authorization from Cal-Optima for William’s ABA services yet so there won’t be any Behavioral Technician coming to the daycare for William.   2 months contract with Magellan has ended on 12/31/2017 so ABEST is waiting for the new contract from Cal-Optima because Magellan is not handling ABA services anymore as of 1/1/2018.  If ABEST doesn’t receive the new contract soon, William will no longer receive any ABA services at the day care; However the sessions at home is still on.

I hope ABEST will receive the new contract soon; otherwise William will spend the whole day at the daycare without any BT to help him.

Christmas 2017

Posted on by MICHELLE N
William and our this year Xmas tree

Dec 25, 2017; William is 4 years old this year. He now knows to open gifts and loves to sing the Jingle Bells songs.

William loves to watch videos of people playing Bowling, Ryan’s Family Toy Review, Family Fun Pack and of course Mickey Mouse, Chíp & Dales, Piggy,etc.
William with Mom & Dad at uncle Vinh’s house.
William and Dad

William and Grandma

Love his innocent smile! Love you son! We took this picture in my car, using the iphone Selfie mode. It was the last day at Mitchell school before the holidays break.

Allergic Reaction to Peanut Butter

Posted on by MICHELLE N

4:45 pm Ms. Nhu from ABEST called telling me that William at the day care was scratching all over his body;  Celestie was the Behavoral Technician  with William at the time.

I called Mr Gary but he did not answer.  Few minutes later he returned my call and his first words were “Your son is fine”.  Then he told me that William threw up, and his eyes starting to get swollen and he was scratching all over his body.  He gave him some Benadryl which I think helped a lot because by the time Tim picked him up, he was scratching less, his eyes still swollen though.  He said he asked Celestie if she gave William some peanut butter chocolate but she said no.  They just had a photo session with Santa Clause at the day care, and Santa gave out peanut butter chocolate and candies to the kids.  Mr. Gary believed that William must eat some of it; otherwise he’d not be allergic like this.

Then when Tim picked him up; Ms. Celestie asked to talk to me on the phone.  She said sorry that she did not know that William is allergic to peanut butter so when William asked for it, she gave it to him.  William took 1 bite then threw the chocolate away. Soon after that he threw up (I’m not sure who changed his clothes but he got home with school clothes on him) and 10 minutes later he started to feel itchy.   She said Sorry so many times.   I’m just so glad that William is fine after this incident.   According to Mr. Gary, he did not have trouble breathing at all so that’s a big relief.

When I got home from work and found that William was happy as usual, jumping up and down; his eyes were still swollen and he scratched his body here and there but other than that, nothing is serious.  And most importantly I don’t see he has breathing problem at all.

And this happened just a few days before Christmas!

Refused to go to Class

Posted on by MICHELLE N
William is eating snack in my driver seat after I picked him up from Mrs. Hana class. He always has at least 10 minutes playing around in my car and eating snack before we head to Children’s world preschool.  William loves Onion rings and Shrimp Chips.

Tuesday morning.  As usual I took him to Mitchell school around 8:15 AM but today he refused to get off his car seat when we arrived at school. I used chocolate and chips but he said no to both; finally I told him he could play in the sand box then he let me carry him of the car seat and put him in his stroller to get to his class.  But then when we got to his classroom, he refused to get in.   He cried with tears coming off his face, sitting down on the concrete floor in front of the classroom door. Finally when I told him he could take the pillow with him to the room, then he stood up and walked in.

Yesterday when I picked him up, Mrs. Hana said that he was easily upset the whole day. He either sat in the corner or ran to the bathroom and sat there without peepee.  Mrs. Hana had no idea what was going on with him.

Today when I picked him up, Mrs. said she found out what’s wrong.  She said she has more students than 1 lunch table can handle so she arranged a 2nd table.  When she asked him to come to the yellow lunch table, that was when he totally lost it.  Other time is that she turned on the Mickey Mouse video, he said “Trolls” and totally lost his temper again.  In her conclusion, if things are not the way he wanted then he’d act out like that.  When she said “we’ll watch Trolls tomorrow” then he’d calm down.  She said, at least now she knows what triggers his behaviors, she’ll know how to calm him down and gradually teach him to tolerate more to changes.

 

 

William’s Favorite Corner

Posted on by MICHELLE N
William’s favorite corner.

Wed Morning.  As usual I took William to his classroom and the first thing he did is to run to a corner.  He does that almost all the time.  Seems like he likes to sit there and watch others playing; or maybe he’s just sleepy?

Mrs. Hana said when he’s upset, he’d run to the corner and sit there.

One time he put his hand under the door that scratched his hand! :(.  Mrs. Hana said this room has 3 doors, and she’s trying to block his access to the doors whenever she can so that won’t happen again.

Picked William at school today, he likes to sit on the stroller.