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Who are you caring for?
Which best describes their mobility?
How well are they maintaining their hygiene?
How are they managing their medications?
Does their living environment pose any safety concerns?
Fall risks, spoiled food, or other threats to wellbeing
Are they experiencing any memory loss?
Which best describes your loved one's social life?
Acknowledgment of Disclosures and Authorization
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid. We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour. APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment. You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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Mostly Independent
Your loved one may not require home care or assisted living services at this time. However, continue to monitor their condition for changes and consider occasional in-home care services for help as needed.
Remember, this assessment is not a substitute for professional advice.
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Hi Pzelak - Part D is prescription drug coverage did they change pharmacies too? How did you get this information? Did you receive a letter, or did someone in the doctor's office tell you this? The reason I ask this, is because if it came from the doctor's office, you may have been misinformed.
To answer your initial question: I don't believe so. That's one of the drawbacks of HMO's. But it doesn't make sense either.
Part C (HMO Advantage) Plans are administered by several different companies and each can be slightly different. I'd call whoever administers your Part C coverage. There should be a number on the back of your membership ID card.
If you don't like the answer provided, you are entitled to file an Appeal/Grievance with the Plan. They are mandated to reply in 30 days. There should be instruction on where to send the letter, etc., in the "Evidence of Coverage" that was sent to you or on their website. If you've misplaced your copy; call that number on the back of your card and request another.
The grounds for your Grievance COULD be this: As an HMO, patients are required to have a PCP that is contracted with the plan. In order for your PCP to refer or authorize services for you at a hospital, they must also contract with at LEAST ONE facility, of which, that PCP is affiliated. How else are you to receive full and proper services? I believe this is in violation of the Federal Health Maintenance Act of 1973, of which, all HMO's must comply.
Perhaps the Provider Relations Dept. (the department that handles the credentialing of providers (hospitals, doctors, labs, etc) overlooked the fact that they have contracting physicians that cannot authorize services within the Plan? (I've seen this happen during contract renewals & it was temporary; frustrating, but temporary).
The problem maybe your physicians hospital may not have signed a contract with your insurance. My doctor has no privlages at our local hospitals. I have to use the hospital physicians then see my primsary when I get out. Doctors have to pay for privlages. Are u sure its not your doctor dropping his privlages? Oh, to answer your question, I think u have to wait for open enrollment and that is Oct, I think.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
To answer your initial question: I don't believe so. That's one of the drawbacks of HMO's. But it doesn't make sense either.
Part C (HMO Advantage) Plans are administered by several different companies and each can be slightly different. I'd call whoever administers your Part C coverage. There should be a number on the back of your membership ID card.
If you don't like the answer provided, you are entitled to file an Appeal/Grievance with the Plan. They are mandated to reply in 30 days. There should be instruction on where to send the letter, etc., in the "Evidence of Coverage" that was sent to you or on their website. If you've misplaced your copy; call that number on the back of your card and request another.
The grounds for your Grievance COULD be this:
As an HMO, patients are required to have a PCP that is contracted with the plan.
In order for your PCP to refer or authorize services for you at a hospital, they must also contract with at LEAST ONE facility, of which, that PCP is affiliated.
How else are you to receive full and proper services? I believe this is in violation of the Federal Health Maintenance Act of 1973, of which, all HMO's must comply.
Perhaps the Provider Relations Dept. (the department that handles the credentialing of providers (hospitals, doctors, labs, etc) overlooked the fact that they have contracting physicians that cannot authorize services within the Plan? (I've seen this happen during contract renewals & it was temporary; frustrating, but temporary).
I'm hoping you were misinformed.