My wife's not home and I need to rant, so here goes.

I take of my bipolar brother. I'm his designated representative for Medi-Cal and receive all his correspondence.
So yesterday I get a letter saying that Medi-Cal Dental is denying a service request. I'm confused because I take him to my dentist and pay out of pocket. Then I look at the form more closely and see that the requesting dentist is in Los Angeles and the denial includes a home visit. My brother lives near me in Berkeley.

I'm a retired hospital CFO and smell fraud attempt so I call the number on the form and eventually get a real person. After I explain things she tells me she can't do anything because I'm not a designated rep for Medi-Cal that doesn't apply for Medi-Cal Dental and I need to go a website, download a form for my brother to sign, send it to them, wait for the acknowledgment and then call back. I tell her that I'm well aware of HIPPA and I don't see why they wouldn't want to follow up on this situation. (In explaining things I give her the dentist's name, address and phone number.) No dice. Got a distinct 'that's not my job vibe'.

I'll get the form and follow up but concerned that no investigation will take place.

Thanks for listening

Can't seem to get the edit function to work. Should say "although I'm a designated rep for Medi-Cal, that doesn't apply to Medi-Cal Dental"

Sorry to hear about this.
Medical Billing is a flat-out nightmare enough as it is.
Perhaps the State Attorney's General Office would like to know about this "claim"?

DiabloWags said:

---

Medical Billing is a flat-out nightmare enough as it is.

---

You got that right. But if billing is nightmare getting a physician coming in from out of state set up on Medi-Cal is worse. That was one of my responsibilities for docs we recruited from out of state. Emblematic of the process is that they won't reveal the physical location of the office in Chico that handles the appplication.