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Acknowledgment of Disclosures and Authorization
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid. We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour. APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment. You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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My husband is in Memory Care..we have LTC thankfully. I am reimbursed within 10 days but they only pay after care is provided so Im always 1 month behind. He has been in 3 facilities and his current facility is by far the best with submitting invoice to insurance. It may be the facility submitting incorrect information or they are lagging in their billing. The statements I received from other facilities were so convoluted and inaccurate. It took two months for 1 reimbursement to be submitted correctly from the facility. Im sure you get reimbursed monthly but any delay from the facility or questionable care will cause your payment to be delayed.
Looks like to me when getting a LTC plan you need a lawyer to review the policy. And who would not think that 20/30 yrs ago that there would not be inflation. My daughter makes almost $50 an hour as an RN. When she started out as an LPN she was making $15 an our 25 yrs ago. Worked up to $27 a lttle more than 10 yrs ago. When she got her RN, they raised her to $30 an hour.
To take the stress out of the situation, look into prepaying one month so that payments arrive on time. If you can set up "auto pay" through the insurance company, that would be great or if not, set up the private auto pay situation where you get the deposit and then autopay the LTCI company. Call the billing dept manager and see if he/she can assist or go to the bank.
In my personal opinion this is insurance company standard practice. Do whatever to not pay out on a policy. Ever. The LTC have additional issues that a lot of these were done by companies that haven’t existed for decades now (John Hancock sold its LTC unit like in 2011) plus policies based on 1980’s health care.
Fwiw my moms 2nd and much better NH, they had a sign in the entry area that they did NOT take LTC insurance for payment. One day I was topping up moms personal needs account & chatting with billing and asked him why and got an earful: that for them (smallish but well established NH group) it was more cost effective to do private pay, MediCARE and Medicaid only and not deal with LTC insurance ever! as they flat took too long to pay and were forever foot dragging on needing clarification and additional details to process a claim. Lots of back n forth. That his & back central office time to deal with the bs the LTC companies wanted especially on educational info on nursing and therapists staff and their time sheets was crazy town. Not worth doing when the M & Ms pay basically in real time once a facility enters that days bed count. They kept abt 1/3 beds always with rehab patients and that kept them profitable as these were Medicare & easily double if not triple for reimbur$$$ment.
The issue often is - especially for older LTC policies - is that they are written for nursing care based on how care was done last millennium. So policy is for an RN doing in a home visit 30 hrs a week at $18 hr. Lol. With no inflation rider. No way RN charge $18 hr in 2023, so insurance billing clerk or family has do a staffing adjustment waiver to get a CNA for $18 hr OR pay for a RN @ $48hr to allow differential paid. This might be why there is a delay???. I’d look to see if there is a pattern as to the payments, & if so, it’s a paperwork filing that’s happening. There’s a document that has to get approved, then payment happens, that my guess. LTC doesn’t pay forever, so try to find out & soon what the end point is. So that you & the rest of the family are ready for when that day comes.
Also I doubt they would pay weekly on the plan, more than likely monthly. I so agree with you that insurance now takes the stance of "no, we aren't paying" and only after a whole lot of foot work by the insured and their providers, will they cough up the money. They hope that you will be too impaired or too worn down to follow up, esp on smaller claims.
Well I guess it depends where you live, for Louisiana, the Insurance Commissioner traditionally goes to Federal Prison. I kid you not! The current one Jim Donelon has run a good office but by & large if too many complain an insurance carrier will withdraw from the State. It can pay back premiums as needed and leave, or just not do renewals and leave, it’s legal to do in most places. Except for New York State and up in NE corridor, most allow this.
The 3 past Louisiana Insurance commissioners, Jim Brown, Sherman Bernard, Doug Green all went to prison. We right now are amidst a near total melt down on homeowners insurance getting issued for coastal LA & MS as most carriers are not doing renewals. It’s pretty frightening.
lil factoid, Jim Browns daughter is Campbell Brown, writer. She was anchor on NBC wkends abt 20 yrs ago, super nice.
One is fortunate to be reimbursed in a month's time. However in my mother's situation the LTC would delay every few months because they had sent out reviews wanting to know if patient still needed AL.
While a facility may not accept direct payment from LTC, a good one can handle and expedite the responses in order for reimbursement.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
the Assisted Living my Mom is at has been so good about billing. They now send it by email as the company kept claiming they weren't getting the fax.
i am copied on the email and there has been no more hanky panky.
keep an eye in these companies, some are difficult such as the one my parents had.
Do whatever to not pay out on a policy. Ever.
The LTC have additional issues that a lot of these were done by companies that haven’t existed for decades now (John Hancock sold its LTC unit like in 2011) plus policies based on 1980’s health care.
Fwiw my moms 2nd and much better NH, they had a sign in the entry area that they did NOT take LTC insurance for payment. One day I was topping up moms personal needs account & chatting with billing and asked him why and got an earful: that for them (smallish but well established NH group) it was more cost effective to do private pay, MediCARE and Medicaid only and not deal with LTC insurance ever! as they flat took too long to pay and were forever foot dragging on needing clarification and additional details to process a claim. Lots of back n forth. That his & back central office time to deal with the bs the LTC companies wanted especially on educational info on nursing and therapists staff and their time sheets was crazy town. Not worth doing when the M & Ms pay basically in real time once a facility enters that days bed count. They kept abt 1/3 beds always with rehab patients and that kept them profitable as these were Medicare & easily double if not triple for reimbur$$$ment.
The issue often is - especially for older LTC policies - is that they are written for nursing care based on how care was done last millennium. So policy is for an RN doing in a home visit 30 hrs a week at $18 hr. Lol. With no inflation rider. No way RN charge $18 hr in 2023, so insurance billing clerk or family has do a staffing adjustment waiver to get a CNA for $18 hr OR pay for a RN @ $48hr to allow differential paid.
This might be why there is a delay???. I’d look to see if there is a pattern as to the payments, & if so, it’s a paperwork filing that’s happening. There’s a document that has to get approved, then payment happens, that my guess. LTC doesn’t pay forever, so try to find out & soon what the end point is. So that you & the rest of the family are ready for when that day comes.
The 3 past Louisiana Insurance commissioners, Jim Brown, Sherman Bernard, Doug Green all went to prison. We right now are amidst a near total melt down on homeowners insurance getting issued for coastal LA & MS as most carriers are not doing renewals. It’s pretty frightening.
lil factoid, Jim Browns daughter is Campbell Brown, writer. She was anchor on NBC wkends abt 20 yrs ago, super nice.
Write to the State Insurance Commision.
While a facility may not accept direct payment from LTC, a good one can handle and expedite the responses in order for reimbursement.