Q I'M HOPING YOU CAN help me because I'm at the end of my rope.
In 1989, I was a young, single college woman living away from my parent's home on a permanent basis. I discovered that I was pregnant and after some trouble with my boyfriend turned to Social Services for help.
I worked as far into my pregnancy as I could and, on Oct. 1, 1989, my child was born. At that time, I was receiving public assistance, food stamps and Medicaid. There was no problem at all with my case at that time. Then about two months later, my doctor's office contacted me to let me know that their bill for the delivery of my child had been denied by Medicaid, which apparently thought I was still covered under my father's insurance.
When the semester ended in May of 1989, and being on welfare, I was neither. I contacted my social worker, who instructed me to obtain written evidence from my insurance carrier stating that I was no longer covered. This I did. I thought that would take care of the problem, but in August my doctor sent me a bill and a note stating that their request for payment had been denied.
I called my worker again, who assured me that all the necessary changes would be made on their computer and it would take a week to reach Albany. I called after that time and was assured it was all right for my doctor to rebill. He did, and was again rejected. My caseworker -- who is now my former caseworker since I am off social services altogether -- said she had done all she could and gave me an 800 Albany number to call.
After calling about 200 times, I was transferred another five times before getting through to the Medicaid office. I was told my problem had to go through my local office here in Buffalo. My doctor wants the $1,100 he is due from Medicaid. -- J.S., Buffalo
A WE THINK WE FOUND the way out by contacting Department of Social Services ombudsman Thomas V. Aurelio, who tells us, "Family coverage for this client, under her father's contract, was confirmed by her insurance carrier on May 8, 1989, and entered on the Medicaid Management Information System.
"Her father's insurance carrier did make one payment to her doctor for services rendered on May 8, 1989.
"On Sept. 7, 1990, it was verified by a telephone call to her former insurance carrier that her coverage terminated on June 30, 1989, and the insurance cancellation date was entered on the MMIS system. At not time did the letter sent by her former insurance carrier reach the Department of Social Services.
"Contact has been made with her doctor's office and it was explained that the last submission to Medicaid was made prior to the date the insurance coverage was deleted and they have been instructed to rebill Medicaid.
"There should be no further problems.
"If there are any other medical bills she is having a problem with she can contact Mrs. Patricia E. Sobolewski, supervisor, Erie County Department of Social Services at 858-6597 for assistance."
. . . To Brenda Whatley of Buffalo from USA Inc. in Marina del Rey, Calif.: "We apologize if there has been a delay in the delivery of her gifts and are manually sending them to her. Keep in mind that she may still receive gifts in the mail as a result of her original entry." . . .
. . . To Dorothy McCaffrey of Eggertsville from the customer service department of the U.S. Buyers Network in Roanoke, Va.: "A refund check in the amount of $7.50 is being issued for the non-receipt of her Magic Hangers. She may expect to receive her refund within the next two to three weeks." . . .
. . . To Dorothy Sullivan of Cheektowaga from Max Factor's Nail Care Kit offer in Syosset: "Her kit was shipped to her on Sept. 17 via bulk-rate mail. Since the kit has not been received we are shipping another one." . . .