HELP! Tracy B or Vicki Or Somebody with Medicaid appeals information
I need some help with what to do next... This is going to be long and I hope you all can understand it..I was denied once, twice and then I requested an administrative hearing... I thought that that was another hearing that I would attend, it wasn't. It was just them looking over the documents that were already in the system.. Those documents were WRONG (it was stated that my BMI was 37, it is 47+, that I was not on medications, I am on medications) and in the appeal request that's what I stated..that they were wrong and I was going to submit the documentation needed ....(I had a letter from the foot doctor stating that she would not due surgery on the fracture of my ankle until I lost weight) They wanted the xrays, the second hearing was a phone hearing so I did not take the xrays...They denied because I didn't submit the xrays..So I requested the administrative appeal so I could take the xrays. So the administative appeal was NOT a hearing, I just got the letter in the mail today that it was a final decison and I was denied...If I want to fight it I must appeal through my county court of common pleas, which of course I will call legal aid Monday and do, but it is driving me crazy that there is no one at the hearing office that will listen that the facts that they are denying me on, are WRONG! I also called my surgeons office and with the last appeal it stated that with my new information (ankle fracture) that I could resubmit my request for surgery and it would be reconsidered.... Where does that put me.. the surgeon's office said that they would resubmit for me with the new informationa and xrays BUT here is the question finally....Will they deny because of the administrative appeal denial or will they reconsider with the new information and documentation (xrays) if I resubmit the actual surgery request...I waited 6 weeks for a hearing date so I could take in documentation, just to get not hearing and a letter in the mail denying me...with the wrong information stated on it....HELP!!!I know why some people give up BUT I am not going to, I am just not sure what the next step is....
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