I found an adult easy child in Juvenile Justice Authority!

Discussion in 'General Parenting' started by C.J., Aug 28, 2007.

  1. C.J.

    C.J. New Member

    I replied to a post a few days ago about schools, courts, Residential Treatment Center (RTC)’s being run by former difficult children about the problems I had while N* was placed at an Residential Treatment Center (RTC) for 90 days earlier this year. I complained about the $1000 that my insurance/medicaid didn’t cover that I may have to come up with. Anyway, I’ve been conversing with N*’s case manager and his supervisor about the information coming to me in bits and pieces, half-truths, and months after the fact.

    Today, I spoke with my insurance company, and Medicaid. Seems that the Residential Treatment Center (RTC) billed the insurance company for $3800 for “health services”, which included psychiatric evaluation, behavioral health, residential facility, and DETOX. My kid was in a secure juvenile detention facility for the preceding 21 days. There was no need for detox. In fact, drugs have NOT BEEN my kid’s problem. My insurance paid everything but $1000. Medicaid paid $1900 (half of the billed amount). So far, it seems that the Residential Treatment Center (RTC) MAY have billed for services not provided and received more than 100% of the amount billed. Ugh!

    The supervisor is so mad that she is requesting billing info for services rendered from the Residential Treatment Center (RTC) while N* was a resident. We may have uncovered sloppy record keeping at best, or some other “insurance fraud” type situation at the worst.

    Before we ended the call, the supervisor said that at a JJA retreat last week, it was brought up that some felt a “parent advisory board” or something similar to it, could be beneficial for the people who work with our kids throughout all the facets: Criminal – from intake, to arrest, charges, detention, visitation, court hearings, sentencing. If judge determines PRTF/Residential Treatment Center (RTC) – intake, insurance, Medicaid, family counseling, medications, schooling, etc. If judge determines incarceration to juvenile correction facility – intake, health care, medications, counseling, schooling, etc. She asked if she could pass my name along. I couldn’t say yes quick enough. Nothing may come of it, but it’s something I’ve been saying is needed since the first law enforcement involvement I encountered when N* was 13.
  2. mrscatinthehat

    mrscatinthehat Seussical

    Gotal love it. These people can be so frustrating. Hope you get the billing figured out.

  3. DammitJanet

    DammitJanet Well-Known Member Staff Member

    Cj...I didnt reply to your first post since I didnt want to stir up a pot that might not be relevant but....

    I used to be a fraud investigator for Social Services. I cannot tell you how much fraud goes on in the medicaid program...and not just on the client end. The provider end is probably an even greater drain on the program.

    If you could, and you are legally entitled to request these records, get copies of all services billed to both the insurance companies and medicaid and then verify if they were actually done or double billed. I have seen cases where providers billed to remove the same teeth 4 and 5 times!

    If you think there is medicaid fraud going on you can call the medicaid fraud hotline. It should be in your local phone book under social services.

    This is one of my pet peeves.
  4. C.J.

    C.J. New Member


    I thought about this some more. The services were billed to "Student Health Services" on the EOB, which has a FEIN (Federal Employer ID Number) that belongs to the State of Kansas. I checked "SHS" with the KS Secretary of State. No such name was registered as a business in KS. My insurance co would only tell me that SHS had a PO box in NY where the check was mailed. She wouldn't give me the address, but gave me the phone number...which turned out to be the Medicaid Billing Service.

    When I talked to Medicaid, the woman there said that KS set up their billing that way, with $$ sent to NY, but if Student Health Services has a FEIN for KS, why would Medicaid be sending $$ there, and not directly to the Residential Treatment Center (RTC) that provided the service? That seems really odd to me.

    I think once I get an accounting from the Residential Treatment Center (RTC), and compare it to the Medicaid payments and my insurance company's payments, if there is a case for fraud, I will ask that it be prosecute. I hate seeing money go to waste - especially tax payer money, because nobody ever seems to care that it gets wasted.

    Thanks for the addl info.

  5. Big Bad Kitty

    Big Bad Kitty lolcat

    Now this is what I call a

    :warrior: <span style='font-size: 26pt'>!</span>