- Over 25 years of experience in both Community Medical Assistance and Long Term Care Medical Assistance Eligibility.
- Hands on Approach with our team of Attorneys, Advocates, and Community Outreach workers.
- We can assist in the Medicaid eligibility process by visiting you at your home, in the hospital, or in our office.
- Actively file Medical Assistance Appeals.
- Establish Disability for Medical Assistance Eligibility using a holistic analysis.
- Help in the Medical Assistance application for pregnant women and families with children.
We take great pride in our hands on patient contact and patient interaction. We simultaneously attempt to maximize collections for the facility while obtaining the maximum potential benefits for the patient. We are always sensitive to medical and social issues of the applicant. We have over 25 years of experience in handling Medicaid eligibility, SSD (Social Security Disability), and SSI (Supplemental Security Income) initial applications and filing appeals of denials.
Our Institutional Services
Community Medicaid Eligibility Including Filing Initial Applications and Obtaining Documents to Establish Eligibility
This includes obtaining hard to get documents such as bank statements, deeds, life insurance information, and medical reports from physicians. We directly assist current and former hospital patients in completing the face-to-face interview with the Department of Social Services caseworker. We help file Medicaid applications and appeal improper denials. We also assist undocumented aliens in obtaining Medical Assistance for emergency services. The following individuals can potentially qualify for community Medical Assistance.
- Over 65 years of age
- Under 21 years of age
- Caring for a related child in your home
- The parent of an unmarried child under the age of 21
We also assist individuals in Medical Assistance Eligibility based on spend-down.
We can also assist individuals in applying for MCHP benefits.
The following individuals can potentially qualify for MCHP eligibility:
- Children under the age of 19 whose countable income is that or below 200% of the federal poverty level.
- Pregnant women of any age whose countable income is that or below 250% of the federal poverty level. MCHP applications can be filed at the local Department of Social Services or the local Health Department.
Long-term Care Eligibility
This includes initial long-term care Medicaid applications and Reconsideration applications. This also includes assisting individuals in reducing assets when appropriate to qualify for Medicaid at the earliest possible date. We are also able to obtain hard to get documents, such as bank statements, deeds, life insurance information, and medical reports from physicians.
At Fred S. London, P.C., we will either conduct the face-to-face interview on behalf of a nursing home resident or accompany a family member or a family representative to the Department of Social Services for the long-term care face-to-face interview.
The applicant must be certified as medically eligible for nursing facilities. This requires the applicant’s physician to complete the Medical Eligibility Review Form (DHMH-3871). The Level of Care must be approved by the state before Long Term Care Medicaid eligibility can be established.
Pre-screening for Long-Term Care Facilities
The benefit of an attorney pre-screening a potential long-term resident is to identify problems at the earliest possible stage. This will allow institutions to only accept truly Medicaid eligible individuals if that is consistent with their business plan.
Medicaid Appeals to the Office of Administrative Hearings, Board of Review and Circuit Court, and Court of Special Appeals
We have 12 attorneys that handle Medicaid appeal hearings and SSD (Social Security Disability) and SSI (Supplemental Security Income) hearings. We have an excellent rapport with the Office of Administrative Hearings. We regularly file further appeals to the Board of Review and to Circuit Court. We have the ability to write persuasive briefs to both the Circuit Court and the Court of Special Appeals on important Medicaid issues.
Constant Communication with the Department of Social Services and Department of Health & Mental Hygiene Regarding Medicaid Policies and Procedures
As attorneys, we rely on the Code of Maryland Regulations (COMAR). These statutes regulate the Medicaid Program. We also closely monitor any changes in policy and procedure from the Department of Health & Mental Hygiene. We also monitor any changes in the practical application of the Medicaid regulations and policies.
Social Security Disability & SSI Representation
We actively represent individuals in Social Security Disability and SSI applications. The initial Social Security Disability application is a requirement of the Medical Assistance Program. We have attorneys who handle Social Security Disability and SSI eligibility. This includes the initial application and all appeals including hearings in front of Federal Administrative Law Judges. We also thoroughly develop all medical evidence to establish disability at the earliest possible date. This will also assist in establishing Medicaid and Medicare eligibility at the earliest possible date.
In-Service Training for Doctors, Social Workers and Other Health Professionals
We actively reach out to our clients, physicians, social workers and other health care professionals to explain the Medicaid process. We have developed a presentation to clearly explain the Medicaid regulations and the forms that are required by the State Medicaid Program, as well as the Federal Social Security Administration/SSI Program.
In appropriate situations, we file hospital liens to protect the interest of the health care facility when there is potential third party recovery. We file the hospital lien in the appropriate jurisdiction to maximize the revenue of the facility.
- File estate claims.
- File guardianship petitions.
- Negotiate with attorneys regarding settlements and payments.
- Negotiate with payments and enter into voluntary payment arrangements if approved by the health care facility.
- Open estates for the purpose of establishing Medicaid eligibility.
- Insurance denial review including private insurance companies, as well as denials from the State Medicaid Program.