WARNING for Coventry cares KY patients
Posted in the London Forum
#1 Jul 26, 2012
First off not here to discuss lazy people who fraud or whatever. This is for people who need and receive medicaid legally and need it.
Coventry is starting to bleed and bleed bad. Trying to change over too quickly and to cheaply is starting to bite Coventry in the butt. And Medicaid patients WILL suffer.(baptist healthcare is on the possible discountine list!!!)
They are constantly "re negotiating contracts" and then conveniently offer such low and slow or nonexistent reimbursements that pretty soon, I'd say in the next 12 months the availability of medical care for medicaid patients will be an absolute nightmare.
The emergency rooms will be even more over run than nowadays.
If you, your grandparents, or your children have a medical need and they/you are on Coventry you had better get it taken care of quick.
Providers are dropping like flies hourly.
And the providers that are still accepting Coventry are going to be absolutely packed and overworked.
If you look at the Coventry web page under providers, the list looks wonderful even many states and fine hospitals are listed, however when you call and ask about the providers, they tell you that most doctors listed have dropped Coventry and that the list has not been updated.
Also the provider book is no longer valid.
Providers are dropping so fast they cannot keep it updated.
So make your appointments and get your problems looked at , and get your medicine cabinet stocked because its goin to be tough, and deaths from simple illnesses will be accumulating
#2 Jul 26, 2012
Thank you for posting the story.I posted on another thread some time back that doctors were retiring and some relocating or just quitting all together and I got made fun of.
I had a friend that works in the medical field tell me that their office had to get a loan to meet payroll and cover expenses because payments from some of these companies were so slow in paying.
Some people wont face reality when you tell them something.No one can stay in business if they dont get paid.Being a doctor no longer means wealth especially if you are trying to pay your education off while running your business and no money being paid to them in a timely manner to pay their overhead.
Times are getting interesting for sure.Going downhill like a snowball on its way to he11.
#3 Jul 26, 2012
Write ky gov-
the Gov has said that managed care WILL work and he is going to make it work. Well its obvious that he needs a second opinion for the people he serves.
If you have been putting off dealing with a medical problem you should consider getting started on taking care of it. Its going to hit rock bottom before any changes are seen and YOU may be the one without a doctor to see you.
Yes its not fair that the weight of the healthcare system should be placed on doctors. Making doctors do charity simply by using guilt of sick people who have no one else.
If 80% of doctors start losing medicaid contracts, the other 20% will be OVER-RUN, it will NOT work.
Medicaid must raise their reimbursements
Write our governor and our congress people to let them know how Coventry is a continued failure.
You have to make noise to get attention. Writing congress and the gov is free online.
This is organized death camp, and the march has started.
Write ky gov-
this cannot last 3 years, people will start getting violent when their children are dying in the street because they cant get into see a doctor and are limited to 5 medicines a month no matter the condition.
You can only push the poor so far.
"when you got nothin' you got nothin to lose"
#4 Jul 27, 2012
well there is Coventry care and Ky Spirit,which many dont take and WellCare.so what does one do ?
Who do you choose.I no Ky spirit has a bad rep too so do we all go to WellCare.I dont know anything bout it.
#5 Jul 27, 2012
The amount that these hospitals and doctors offices get paid for services is crazy for the things that they provide. The only reason the doctors office and hospitals arent taking Coventry and Kentucky Spirit or that they aren't renewing their contracts are that they do not reimburse as much as Wellcare. They are all in it for the dollar!!!!! Patients will continue to receive the care they need!!!!!
#6 Jul 27, 2012
#7 Jul 27, 2012
"Since Kentucky switched to managed care organizations from fees-for services last November, the Lexington Herald-Leader has reported in detail on problems Medicaid members are having getting care, as well as on the problems providers are having getting paid by the managed-care insurers."
"Lemaster said the bulk of the problems have been with Coventry which has denied 82 percent of their claims, she said. The remaining 18 percent are being held because the company has not loaded billing codes for supplies into its system, even though Coventry reportedly has had the codes since November."
Read more here: http://www.kentucky.com/2012/01/27/2044870/ho...
#8 Jul 27, 2012
#9 Jul 27, 2012
"Coventry Health Care Inc. has extended CEO Allen Wise's contract for two years, securing his services through Dec. 31, 2013, and boosting his compensation to new heights.
Effective Jan. 1, Wise earns $900,000 in base salary annually and will be eligible for up to $1.8 million in bonuses each year, according to a Securities and Exchange Commission filing made public Monday. Furthermore, Wise will receive $7.6 million worth of stock awards in both 2012 and 2013 that would become payable upon the the health insurer's reaching earnings-per-share and revenue targets."
WOW can you see where coventry is bleeding? Is it the poor sick people bleeding them...???
Or the fat cat CEO's?
#10 Jul 27, 2012
What the hell is wrong with Coventry.Seems like they are deliberately trying to sabotage the program.
But I know what you are saying is true.My neice has been waiting on an approval for a procedure for months now and the doctor hasnt been paid for what he has already done.No one can run their business if they arent being paid on time.She switched from Ky Spirit when it started because she was having problems getting care..Sounds like they dont really want the program to work.
#11 Jul 27, 2012
#12 Jul 28, 2012
Sounds to me like you really don't "know" as much as you think. If you KNEW anything you'd know that Medicaid pays providers the least of any insurance out there, that regardless what the provider charges Medicaid (or the MCO) pays what they pay and the rest is written off. So now with this change to MCO and them slow to issue payments to providers... And most patients assuming all doctors are rich and paying $5 a month on their bill, some smaller providers have had a rough time meeting payroll and the end result is employees loose jobs.....
#13 Jul 28, 2012
Typical of most companies.Look at what the charity CEOs rake in while people donate think its going to the poor.Look at the bank failures the tax payers bail out.The CEOs still got paid billions while the people lost most their investments.Look at the salaries of the people over any welfare program,same thing.Look at JCMorgan/Chase..many people lost millions in investments and lost jobs,etc.Now JPMorgan is getting rich off distributing food stamps while they outsource the jobs to India.
Yet crazy people will get on here and yell about food stamp people all the while gluing their mouth shut about the ones that caused the mess and took billions of their tax money.Its always the little food stamp person.People will wake up after it to late and realize the local people is where they should be helping instead of the rich.
As for this thread I know the person posting this info is correct.Many doctors and dentists are still waiting to be paid for services and the cash flow is just not there for them to run their office.If they arent getting paid for their services they cant operate.As stated they dont make anything off the patients compared to the ones with other insurance.Their actual bill may be $100 and they get reimbursed $30.
#14 Jul 28, 2012
Yes, and before managed care people could go to many different places and spread out the medicaid patient load. Now with coventry and the other 2 (wellcare/spirit) they are low balling payments - so many places are cancelling/no longer accepting ky medicaid.....sooo
What do people think will happen when only 10% of medical providers who accept medicaid start to have 95-100% caseload of medicaid clients?
If one store in town was the only store that sold toilet paper....how long would it be before they sold out?
This managed care states that it wants to manage the health of Kentuckians by increasing access to quality medical care, work on prevention, and better the health of its clients. LIES.
Their plan is to DENY, DENY, DENY until you give up and die. Or die waiting. They purposely do prior authorizations by hand....they do not/wont do them electronically. This was set up especially to SLOW down response time, so that some people would give up, die, or something else instead of getting what a licensed doctor has ordered.
They will force the poorest of the poor to travel long distances instead of being able to have access to closer medical facilities. Poor people do not have the resources to travel (gas!) and stay in motels and eat out for days at a time.....and coventry knows it.
Its a death plan people. The rich are skating away with millions, and we are failing to protect the sickest and poorest among us.
The rich have their BMW's, but will our cripple children have their wheelchairs? Will granny have that surgery? Will the heart patients get their meds?
If anyone reading this has had problems with:
1.Being forced to change doctors no matter the distance
2.Losing meds that you were on for years
3.Denial of services
4.Denial of hospital stay
5.Other problems with Coventry or ky managed care.
Please tell your story!
#15 Jul 28, 2012
Yes before you could go to any doctor you chose that accepted Medicaid.I moved here from an area in Mississippi that had very few doctors that would accept Medicaid because of the low amount it paid.
I felt so sorry for my neighbor friend.She was low income and worked as much as she could but did qualify for Medicaid.Even a simple dental visit she had to go 45 miles to find a dentist that accepted it and the ones that did accept wasnt the good ones that had a lot of patients.So that gave her low grade care to start with.I am semi retired and I always took her to the appointments because she really couldnt afford to go.There was only one doctor in the area that accepted Medicaid.Small town yes but still over bearing for one doctor.
Found later that he was only there because of some agreement due to his medical school being paid through some program.So now she has to go out of town just to see a doctor because he left once his time was up.
This is whats going to happen with all the new medical care thats going into effect.It will stop paying for a lot of things thats paid for now.It will limit amounts spent and what can be spent of who based on a number of things.At some point many of the doctors are just going to close up shop because if you cant earn a living you cant stay in the job.
Approvals now take so long that you can be really bad off or have much worse problems before you can ever get an approval back.I know someone thats waiting on an approval that was submitted in March,had the doctor check why it was taking so long and all they got back was 'We are backed up with paperwork"
Well of course they are backed up because they drag and do each by hand.Plus in my opinion its a delay on purpose so not to pay for the care.
We can get use to it.What we had is going to look like luxury compared to what we are going to be getting in the future. Bad part is people will look at one thing and get all mad and yell for something else never considering the whole picture and what they may be getting will be much worse.
Quiet a few drugs are already having to be substituted for others that dont work as well because the providers will no longer pay for them.
#16 Jul 30, 2012
Actually, managed care was designed to ensure that the people who NEED care would still have care available in the future..... Medicaid program had to be reorganized because so many people abuse the system. Many people on Medicaid run to the ER (emergency room reserved for serious/life threatening Illness) weekly, monthly, etc for simple illnesses such as a runny nose and cough which can be treated much cheaper at a Doctor's office. Managed care is designed to "manage your care" if it appears you are over utilizing unnecessarily then you may be assigned a caseworker to help you learn ways to cut down on healthcare costs, learn healthier habits. In other words having a Medicaid/MCO card shouldn't mean that you don't have to be concerned about how the bill will be paid to the point that you use it like a credit card with no limit...
Nothing wrong with needing help... But if you need help you should be grateful for it and not take advantage of it. Save some for others that may need it in the future.
#17 Jul 30, 2012
Seems like its going from one extreme,like over use of the Er, to the opposite where you cant get seen or the meds you need for the care places using paperwork to hold up payments to the providers.
Only going to get worse it seems.We best appreciate anything we have because soon we wont be getting much care at all.Maybe its best that way I dont know.Maybe we are just put here to live and to die.Wouldnt much medical care in the past and people treated them self as best they could and they either survived or died.Thats what life is I suppose.
#18 Aug 17, 2012
1st poster it appears you knew what you were speaking of..seems St Josephs hospital is now included..What a mess this is becoming.
Get the feeling this type stuff will continue until everyone has almost NO healthcare.
Just saw this on WKYT
Largest KY heath system terminating contracts with Coventry Cares
LOUISVILLE, Ky.(AP)- KentuckyOne Health says it is terminating contracts at all its facilities with Medicaid provider Coventry Cares.
In a statement Thursday, KentuckyOne Health said the terminations will be effective at former Jewish Hospital & St. Mary's Healthcare facilities on Nov. 1 and at former Saint Joseph Health System facilities beginning on Dec. 1.
The announcement came after Coventry gave notice that it would not participate at two hospitals owned by the health system - Our Lady of Peace in Louisville and Taylor Regional Hospital in Campbellsville.
The statement said KentuckyOne Health is the largest health system in Kentucky and will continue to work with the three other Medicaid providers that contract with the state.
#19 Aug 17, 2012
Thank you, as people who bothered to read my posts can see I back up what I say with links.
Coventry and managed care in general is out to get all the money they can from KY. They do not care who /how many die.
They dont care about your granny, your baby, your husband or wife.
Coventry denies 90% straight out of the gate, they have their "doctor" look over another doctor/specialists report and he then says in his opinion this service is not valid/not needed.
Its organized killing.
What is going to happen when there is only one or two family doctors accepting coventry?
Whats gonig to happen when only one area hospital (most likely UK) is the only one taking coventry?
Its going to collapse. The medicaid load must be spread out and not heaped onto only a few.
I feel as if KY knew this was going to be bad thats why people with severe brain injury, nursing home people and special ed institutionalized peoples were excluded from having to me managed by mco's.
Thats right, tradition KY medicaid is still in effect for those people.
Well they say to switch mco, but the EXACT same thing will happen when tons of people switch to one mco, it will COLLAPSE.
I guess for now switching to whatever a local doctor recommends is the thing to do, long term....we need to write congress, complain, protest....get informed and involved.
#20 Aug 17, 2012
Kansas developed MCO's to manage their medicaid, it took 18 months.
Ky tried to do it in 6 months.
KY knew that people would suffer. The gov knew people would suffer, he did not care he is not running again.
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