x-sender: governor.haley@sc.lmhostediq.com x-receiver: governor.haley@sc.lmhostediq.com Received: from mail pickup service by sc.lmhostediq.com with Microsoft SMTPSVC; Wed, 26 Oct 2016 10:41:47 -0400 thread-index: AdIvlxQYbW809l1jT+KfFENezyt4UQ== Thread-Topic: SC MEDICAID From: To: Subject: SC MEDICAID Date: Wed, 26 Oct 2016 10:41:47 -0400 Message-ID: MIME-Version: 1.0 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: 7bit X-Mailer: Microsoft CDO for Windows 2000 Content-Class: urn:content-classes:message Importance: normal Priority: normal X-MimeOLE: Produced By Microsoft MimeOLE V6.1.7601.17609 X-OriginalArrivalTime: 26 Oct 2016 14:41:47.0244 (UTC) FILETIME=[143042C0:01D22F97] CUSTOM Mrs. Kelley S Yelvington 2625 QUINN RD CHESTER SC 29706 YELVINGTONBILLS@YAHOO.COM 8033747046 8033747046 BOARDS SC MEDICAID 12.31.113.99 Good Morning, I am writing today to voice my concerns with SC Medicaid's mileage radius for coverage. My son is on the Tefra program as his secondary insurance. He has numeorus health concerns one of which is Epilepsy. My son is seen within the Carolinas Healthcare system in Rock Hill, SC and Charlotte, NC. My son's neurologist left her position and she referred him to an epileptologist within the same Carolinas Healthcare system pediatric neurologist group but that is based out of Concord NC. I have been informed that I have to get prior authorization, even if for just a office visit, to see his epileptologist becuase she is outside a 20 mile radius of South Carolina. I am fighting a bill now that Medicaid doesn't want to pay for a 24 hour EEG that my son had at the hospital in Concord b/c his previous neurologist sent us there after there was no room for him at the CHS Main, in Charlotte becuase it was outside the "radius". Why do we have to deal with this? There are very few choices for Epileptologists in this area. To stay within SC I would have to move my son's neurology care to Spartanburg/Greenville or take him to MUSC. I like having my son's doctors in the same healthcare system becuase they can read each other's notes and stay on top of what is going on within his team of specalists. They can communicate about medicines that may or may not affect his other conditions, etc. I feel like if you are a member of SC Medicaid you should be able to go to neighboring states for medical care if need be. The office of my son's epileptologist is 25 miles from his previous neurologist that I had no problems getting medicaid to pay becuase it was within the "radius" Do you know how hard and long it takes to get a authorization from medicaid? My son's epileptologist office can't even call medicaid and get an authorization, I have to call his primary doctor and they have to do it. So if it comes another time that my son has to have another test or EEG ordered by his epileptologist I will have to wait for my son's primary doctor to get prior authorization before he can have the test. I think this is ridiculous. I will also mention that we keep our son covered through my husbands insurance so his primary insurance is absorbing most of the costs, medicaid doesn't even have to pay the full amount. My husband and I are working parents with full time jobs. We don't have time to sit on the phone and chase authorizations so that our son can been seen by specalists that can help his conditions. I will have to take time today, while I am at work, and call Medicaid to find out why they are not paying a bill, when there is a authorization number that was obtained for the EEG he had in January. In fact, to my knowledge there may be 2 authorizations for this same test. It's hard enough dealing with what my son is going through, to have to deal with Medicaid having issue with me traveling an extra 25 miles to see a specalist that can help my son with his epilepsy. Is there anything you do to help me with this, Governor Haley?