216
Solutions FAQS |
1. Why does the Disability
process take so long? |
| Answer:
There are many reasons for this, aside from the normal
processing time that it takes SSA to receive, and review
the applications. We have found one main reason for
a delay in the process. When an individual applies for
disability benefits there is an array of applications
and questionnaires that must be filled out. In many
cases, these applications and questionnaires are not
completed correctly or thoroughly by the patients. SSA
is then forced to send these forms out again for completion
leading to weeks of delay in the processing of the applications.
|
Solution:
216 Solutions will not only assist your patients in
properly & thoroughly completing all the necessary
applications and questionnaires, but we will assist
in gathering supporting documentation specifically medical
records needed to expedite the disability claim. |
| |
| 2. Why are so many of my patient’s denied
their disability benefits? |
Answer:
An incomplete application not only leads to a delay
in the disability process, but too often it also leads
to denied applications. In addition the lack of proper
medical evidence to support the patient’s disability
claim is also at fault. |
Solution:
216 Solutions will ensure that ALL medical evidence
is submitted to Social Security and/or the Disability
Determination Services so that an accurate decision
based on all medical evidence is attained. |
| |
| 3. I think my patient is disabled but he/she
keeps getting denied by Social Security. Why? |
Answer:
The Social Security Administration defines a long term
disability as “the inability to engage in substantial
gainful activity for a period lasting 12 months or more.
In addition an individual’s disability must meet
specific disability guidelines in order to be deemed
disabled under the Social Security rules. However, a
Hearing before an Administrative Law Judge can over
turn SSA denials and deem an individual eligible based
on other factors.
|
Solution:
216 Solutions will evaluate your patient’s medical
condition to determine his/her long term disability.
We will use the same 5 step analysis used by SSA to
ensure the proper determination is made and gather supporting
medical documentation |
| |
4. Why must I complete
disability forms for my patient’s? Aren’t
the medical records enough? |
Answer:
The Disability Determination Services is charged with
evaluating an individual claim for disability. An examiner
is assigned to request and review all medical evidence
to support a disability. If the medical evidence submitted
does not meet the specific guidelines required, then
additional information such as questionnaires may be
requested in order to obtain certain information. |
Solution:
216 Solutions will assist when possible in completing
any additional forms requested by SSA. |
| |
| 5. How can I find out the status of my patient’s
disability cases? |
Answer:
Due to very strict confidential rules SSA is not allowed
to release information on an individual’s case
without proper authorization on file. The physician
can obtain information from the patient themselves,
but many times the patient is not aware of their current
status. |
Solution:
216 Solutions represents patients at all levels of the
process. As representatives we obtain specific authorizations
of release that allow us to get status from Social Security
Administration and the Office of Hearings and Appeals.
As a registered member of Team 216 Solutions, you will
receive monthly status reports of all patients referred
to 216 Solutions. |
| |
| 6. How can I decrease my number of self pays? |
Answer:
The self pay population has continued to increase while
the number of available programs has decreased. Still
there are a number of local, county and federal assistance
programs for many self pay patients, finding these programs
is the difficult part. |
Solution:
216 Solutions has vast experience in identifying potential
coverage through the various assistance programs. Our
free services includes a screening of all available
programs for all patient’s to ensure they receive
all the benefits they are entitled to. |
| |
| 7. How can I keep from missing Medicaid billing
deadlines? |
Answer:
Obtaining Medicaid information as soon as the patient
is certified would be ideal. This requires consistent
follow up with patients and TMHP to ensure billing deadlines
are not missed. |
Solution:
216 Solutions understands that Physicians and their
staffs are not in the eligibility monitoring and tracking
business. WE ARE! Our procedures call for a 2 week tracking
process that monitors all cases for approvals and denials
to ensure timely billing or if needed timely filing
of appeals. |
