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Common Problems With Applications/denials


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I've been in contact with LARA and we are running into some issues with applications.  I'm going to start this thread to put out notifications of reasons for rejections as an aid to patients reviewing their locations.

 

First some advisements:

 

1/  Make sure you have medical records to support your certification, and that the clinic you go to copies them for your chart.

2/  Do NOT renew through the mail or over skype, meet with the doctor face to face.  If there is no doctor to sit across the table from you, go to another clinic.

3/  Do a follow up with the doctor every 6 months, even if it by sending in an update.  Confirm the update/follow up appointment is recorded in your chart.  Some practices charge for this update, some do not.  If they do, pay it with a smile, it is there to protect you.

 

Common denial reasons:

 

My legal name is Robert, if I apply I will write 'Robert' as my first name, though everyone in the entire world that knows me knows my name is Bob.  They do not accept Bill for William, Chris for Christopher, or any other 'nickname'.

 

Only put ONE address, your mailing address, on the application (and same for your caregiver).  Putting a PO Box AND your Drivers License address confuses them at LARA, and when they are confused, they deny.

 

Do NOT make any 'corrections' on the form.  If there is a spelling error, do not correct it or make the 'o' into an 'e'.  They will claim the form is altered and deny.  Just do another form and be more careful.

 

Do NOT send a copy, in my practice patients are given the original to send to the state, and a copy for their records.  They are told to send the original to the state, yet we get denials because the copy is sent.  We charge $25 to fix this, don't do it.  Send the original (sign in blue ink if you have to).

 

Keep your paperwork copies after you send the original in.  Most times you can send copies of everything except the form you messed up, or send documentation for the $25 fee, or just send the $75 extra dollars and everything is fine.  You don't need a new doctor's certification unless a/ the doc made a mistake or b/ you don't have a copy of the cert you were given at the time of the visit.  BE SURE TO SEND A COPY OF THE DENIAL so they can compare it to what you sent in.

 

These are just a few of the issues we have seen with denials.  Feel free to add your own, with a suggestion to correct, to this thread.  If you don't know what is needed, put up the problem and I'll try and help you figure it out, my patient or not.

 

Dr. Bob

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Any lack of legible, concise printing on any of the forms may cause an issue when being reviewed at LARA.  One should be as precise as possible when forming letters/numbers onto a form to prevent any question.  If you have sloppy semi-legible printing skills, then have someone that can print legibly do it for you.  Your doctor can use a printer for the certification form.  

Edited by cheapshades
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