Illinois and Medicaid

[csellebrecht]

Anyone have any experience with Medicaid in Illinois. I recently got a script written for a resumed s9 auto and a resumed fx nasal mask. I have the option of going to either Lincare or Apria, unfortunately i chose Lincare. They are now saying that Illinois medicaid doesn't pay for the resumed and they will only pay for the Intellipap by by Debliss.

I don't think this is true and should I settle for the Intellipap or pressure them for what the script was written for?

Any suggesting would be great!

Thanks

Craig

[Julie]

If you're referring to the machine in your signature (under your posts) the Intellipap's newer and does a lot more, especially if you get the software and module for tracking your progress on your computer...

[STL Mark]

Check with equipment providers in your area that are smaller firms than those you mentioned and see if they accept your insurance. Or call the insurance company and see what equipment providers they accept. Then call to them and ask them what they will provide if you give them that script.

If your near the St. Louis end of Illinois, call IV and Respiratory care at 800-719-3335. They are a good firm.

Refer to the desired machine as S9 Autoset when you call or you may end up with an S9 Auto (escape) unit.

[LSAT]

He is talking about Medicaid which is run by the states. No insurance is involved. The benefits are paid by the states...they make their own rules.

[chunkyfrog]

Go for the Intellipap.
Cost wise, even the S9 escape Auto is way more money and an inferior machine.
Medicaid letting you have an Autoset? I kind of doubt it.

[Janknitz]

I don't know anything about Illinois Medicaid, but it's not unusual for a state to have a limited formulary that does specify make and model. But being a public agency, you should be able to confirm that formulary somewhere. Call Apria and ask them.

[Drsleep8]

i just heard that Apria is no longer accepting Illinois Medicaid. Heard it from Apria.

[Wulfman...]

Since this thread got resurrected for some reason, I decided to do a little searching.........

http://www.yelp.com/biz/apria-healthcare-naperville

http://www.consumeraffairs.com/health/a ... hcare.html

http://caselaw.findlaw.com/us-7th-circuit/1524536.html

http://law.justia.com/cases/federal/dis ... 3/2472060/

http://www.justice.gov/archive/dag/pubdoc/health97.htm

http://www.apria.com/wps/portal/apria/h ... p-services

From the above link:

Sleep Apnea Screening

This is an Apria service designed to assist in identifying patients risk of sleep apnea or other forms of sleep disordered breathing.

Features include:

Overnight test performed in the home
Measurement of oximetry, or airflow and oximetry *
Comprehensive analysis and reporting of:
Oxygen saturation trends
Oxygen desaturation index
Breathing disorder risk indicator *
Validated patient questionnaires

* Services may not be available in all states; restrictions apply for patients with Medicare, Medicaid, TRICARE or other government insurance.

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Not in a million years would I use Crapria.

Den

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