Once title 19 kicks in, they send me no bill?

Mica, I am moving this question back up to see if someone can answer you.

Read your contract carefully, it will tell you the co-pay (share of cost).
Forget the director of finance. Get to know the person who actually processes the bills. Make nice and be friendly, be sure he/she can call you on your cell. We did that and it helped a lot.

thank you for your answers.... I had met with her a while ago and we got along, she gave me her email addy then. She was the one who does the bills- the only one apparently because the first one was non-existent because she was on vacation (!) Ok, well, I think it isnt correct I do not receive an invoice so I'll check it out . very strange!

" first one" refers to first bill

Please explain what is Title 19

UncleDave - Title 19 is Medicaid.

Mica - just realize that mom now that she is on Medicaid - aka title 19 - she will need to pay to the NH whatever is the exact amount of her co-pay or SOC (share of cost). The SOC was determined by Medicaid based on her awards letters that stated what would be paid to her for 2016 and is interdependent on whatever mom's monthly income is less a smallish personal needs allowance. The PNA varies by state from $ 35 - $ 105. if mom's income has been going to the NH directly already, then they should have established a NH trust account in her name that her PNA goes into. If that's the case, you should have your name on the account for withdrawals so you can say get $ 100 from it to go to Target to buy toiletries or clothes for mom.

HOWEVER mom does NOT have to have her monthly income go directly to the NH - the NH will press / imply that it needs to be but they cannot require this. Often families do this as it just flat seems easier or they assume it must be done this way.

For my mom, she kept both her SS and retirement going into her bank account and I as her DPOA wrote out a check to the NH for the exact amount of the co-pay each month. Her bank account built by $ 60 each month as that is the PNA for Texas. I did set up a mini-trust account at the NH for mom to use to pay for the beauty shoppe and for candy from the NH canteen and kept it around $ 200 and the NH sent an accounting every 90 days on it to me.

the advantage on this is that it does keep control of finances by family & if mom should move from this NH to another it will be oodles less complicated to do this.

yep Igloo mom's is like this now also. I just thought it very strange that they stopped sending a bill. I have decided to just send a check once a month without one but the lack of any invoices is disturbing... I have no receipts! I am going to call today.

Mica - try to find the States letter approving mom for NH Medicaid. If its just going to mom at the NH, IMHO you really want the State to mail you a duplicate on all correspondence. The letter should state to the penny what moms monthly income sources are & you want to make sure they are correct & pay based on that amount.

Also if mom's state does an annual renewal for Medicaid, you need to get this and not have it just sitting somewhere at the NH unopened and not dealt with. The renewal (TX) I did for my mom had a 15 day submission requirement.....nothing but fun there and it always was delivered either after due date or the day of....

My moms first NH, well they kept all residents mail unopened at the business office, so residents or their family had to know to go and do this. This NH also was beyond incompetent at the business office, I moved mom within the first year once I got her onto Medicaid and billing corrected. My moms 2nd NH had aides distribute mail to the residents in their room and I signed off to allow all mail to be opened. If you continue to have billing issues and moms care is less than what you think could be done, you can move her from 1 Medicaid NH to another & hopefully mich better & closer NH pretty easily if you get the move date to be right at the beginning of the month...& you have to remember to get all of moms medications from the nurses station the old NH as these get filled in multipacks of 60/90 days and medicaid or Medicare won't pay for duplicates....

Finally found the finance person there in person after all this time of no response to phone calls. After title 19 kicks in, they dont send out bills or statements any more!
It would have been flipping nice if she had told me this and responded to me.