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  • Kevin
    Nancy, I firmly believe that having a Democratic Senator or Congressperson helps. The Democrats have always been more willing to go to bat for me, especially
    Message 1 of 9 , May 12 5:39 AM
      Nancy,

      I firmly believe that having a Democratic Senator or Congressperson
      helps. The Democrats have always been more willing to go to bat for
      me, especially when dealing with a Republican administration.
      Unfortunately, my Congressman and both of my Senators are
      Republicans. Maybe I should move across the border to Vermont! The
      caseworkers that I've had recently haven't been very assertive, and
      I often feel that I have to nudge them as much as I've had to nudge
      the Dept. of Labor.

      I've recently enlisted the aid of Senators Sununu and Gregg to
      assist Congressman Bass on my behalf. Hopefully, getting requests
      from three congressional offices will get the attention of OWCP. I
      also spoke with an OWCP "tech person" in Washington, DC about a week
      ago. She seemed empathetic and genuinely nice, so hopefully she can
      navigate the bureaucracy better than outsiders can. We'll see.

      Kevin

      --- In owcp@yahoogroups.com, FourDirect@a... wrote:
      > Kevin,
      >
      > I just had a huge success. For 4 years+ I have been trying to get
      my checks
      > sent to my NY address having moved here from AZ. They have been
      able to easily
      > mail me (at my NY address) all the notifications telling me that
      my medical
      > bills are denied and yet have continued to send my OWCP monthly
      temp income out
      > there! With the help of Senator Schumer (NY US Senate-Dem) I now
      finally have
      > direct deposit. Took congressional intervention on that one!!!
      >
      > Actually, I have ACS working for me now (famous last words). I can
      dialog
      > with you directly regarding my tactics if you'd like. And it does
      help to have
      > Sen. Schumer behind me. Also, I do most of the billing for my
      healthcare
      > providers and have the proper codes now, etc... It just goes on
      and on and on and on.
      > 20 years for me, too.
      >
      > Nancy
      > New York
    • Heidi Fassnacht
      hello kevin, nancy, pat (!!), and anyone else who might be out there, i m sorry to hear about your continued difficulties kevin. i know how exasperating it
      Message 2 of 9 , May 12 10:29 AM
        hello kevin, nancy, pat (!!), and anyone else who
        might be out there,

        i'm sorry to hear about your continued difficulties
        kevin. i know how exasperating it can be, except your
        situation is compounded by decades of dealing with
        this. sorry too pat that it took so long for you to
        just have to pay things on your own. it's good to
        hear from you! nancy, happy belated birthday and
        congrats on your breakthrough with OWCP.

        i've recently had a breakthrough too, getting my
        medical bills reimbursed for most of 2003. i used to
        get approval of my medical appts through my OWCP case
        worker. in sept 2003 when i called OWCP to check up
        on the status of approval for more care (since they
        never call you) i was told i must go through ACS. ACS
        told me i needed prior authorization. so i went that
        route, getting retro active authorization. (i never
        stop going to my care providers waiting for OWCP or
        ACS to get things sorted out. i can't wait that
        long.) after having to send a 20 page fax multiple
        times, and many phone calls, i finally got
        authorization. it's probably taken me around a year
        to get this paid even though it was authorized. they
        came up with every excuse possible, and when it seemed
        they ran out of those, they tried the 'denied for
        untimely filing' one. if they didn't do something
        about that, i was going to get my congressperson
        involved. luckily i didn't have to do that this time,
        but i have before. all i did was keep calling them
        back, call them on the obvious (this page should have
        been on top, not second from the top), and do what
        they suggested (you need to file for change of
        provider for your authorization).

        kevin, although i agree that OWCP and ACS are like
        scapegoats for each other, i have found that although
        there are many problems with ACS, i have had better
        luck with them than with a number of my OWCP case
        workers. the second to last one never called me back
        and she was almost never in when i called. you can't
        deal with someone when you can never talk with them.
        it was exasperating and demoralizing. although you
        never talk to the same person twice at ACS, and they
        don't usually do what they say they will, and so on, I
        would be a little reluctant to get rid of them all
        together. perhaps something could be worked out where
        the lines of responsibility were clearly defined
        between the two (OWCP and ACS), among other things.
        anyway, we could get together some time and talk about
        this more if you like. but i'd best get back to work.

        hang in there!

        heidi



        "In the end, our society will be defined not only by what we create, but also by what we refuse to destroy." John Sawhill



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      • Kevin
        Heidi, Thanks for your note. It s interesting that your dealings with ACS have been very different than mine. From my perspective, it seems that ACS does
        Message 3 of 9 , May 13 5:51 AM
          Heidi,

          Thanks for your note.

          It's interesting that your dealings with ACS have been very
          different than mine. From my perspective, it seems that ACS does
          nothing except enter data, push paper, etc. for OWCP. ACS acts only
          when OWCP instructs it to do so. ACS has a "Prior Authorizations
          Department" but I don't believe it does any authorizing at all. It
          assigns an authorization number, enters CPT codes, determines dates
          of services, and then waits for OWCP to give the go ahead. Despite
          the fact that I have an authorization number and the dates of
          service have been determined to be 11/3/04 to 11/3/05, I cannot
          proceed with treatment because OWCP has not authorized the
          authorization. OWCP says ACS is in charge of authorizations, and
          ACS says " ... authorization cannot be approved at this time
          [because]OWCP has determined that further medical development is
          needed ..." Catch 22!

          Congresspersons and Senators won't deal with ACS because it is a
          contractor and not a federal agency. As long as ACS only has to
          answer to OWCP, it has no incentive to be responsive to claimants.
          I suspect ACS is a willing scapegoat because OWCP is writing the
          checks. I think ACS has to go because it has become a de facto
          federal bureaucracy that operates without proper oversight.

          Kevin

          P.S. Nancy: Do you know when the contract between OWCP and ACS
          expires?

          --- In owcp@yahoogroups.com, Heidi Fassnacht <riverock5@y...> wrote:

          > hello kevin, nancy, pat (!!), and anyone else who
          > might be out there,
          >
          > i'm sorry to hear about your continued difficulties
          > kevin. i know how exasperating it can be, except your
          > situation is compounded by decades of dealing with
          > this. sorry too pat that it took so long for you to
          > just have to pay things on your own. it's good to
          > hear from you! nancy, happy belated birthday and
          > congrats on your breakthrough with OWCP.
          >
          > i've recently had a breakthrough too, getting my
          > medical bills reimbursed for most of 2003. i used to
          > get approval of my medical appts through my OWCP case
          > worker. in sept 2003 when i called OWCP to check up
          > on the status of approval for more care (since they
          > never call you) i was told i must go through ACS. ACS
          > told me i needed prior authorization. so i went that
          > route, getting retro active authorization. (i never
          > stop going to my care providers waiting for OWCP or
          > ACS to get things sorted out. i can't wait that
          > long.) after having to send a 20 page fax multiple
          > times, and many phone calls, i finally got
          > authorization. it's probably taken me around a year
          > to get this paid even though it was authorized. they
          > came up with every excuse possible, and when it seemed
          > they ran out of those, they tried the 'denied for
          > untimely filing' one. if they didn't do something
          > about that, i was going to get my congressperson
          > involved. luckily i didn't have to do that this time,
          > but i have before. all i did was keep calling them
          > back, call them on the obvious (this page should have
          > been on top, not second from the top), and do what
          > they suggested (you need to file for change of
          > provider for your authorization).
          >
          > kevin, although i agree that OWCP and ACS are like
          > scapegoats for each other, i have found that although
          > there are many problems with ACS, i have had better
          > luck with them than with a number of my OWCP case
          > workers. the second to last one never called me back
          > and she was almost never in when i called. you can't
          > deal with someone when you can never talk with them.
          > it was exasperating and demoralizing. although you
          > never talk to the same person twice at ACS, and they
          > don't usually do what they say they will, and so on, I
          > would be a little reluctant to get rid of them all
          > together. perhaps something could be worked out where
          > the lines of responsibility were clearly defined
          > between the two (OWCP and ACS), among other things.
          > anyway, we could get together some time and talk about
          > this more if you like. but i'd best get back to work.
          >
          > hang in there!
          >
          > heidi
          >
          >
          >
          > "In the end, our society will be defined not only by what we
          create, but also by what we refuse to destroy." John Sawhill
          >
          >
          >
          > Yahoo! Mail
          > Stay connected, organized, and protected. Take the tour:
          > http://tour.mail.yahoo.com/mailtour.html
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