If your Louisiana Medicaid waiver services aren’t meeting your needs, your Plan of Care (POC) may need an upgrade. Given how common this type of situation is, there’s a defined process in place to determine whether you truly need additional services. But how long do the review and approval processes take? If approved, how long will you have to wait for your new services, and could there be delays? We’ll answer those questions and more in this article. Read on as we cover the timelines associated with the Plan of Care revision process for Louisiana Medicaid.
How Long Is the Wait for Additional Medicaid Waiver Services in Louisiana?
Let us first tell you that there is no single expected wait time for these types of requests. The POC revision request process involves distinct steps and several different parties (you, your support coordinator, the LGE, and your medical provider). The timelines for these steps will vary a bit. But below, we’ll give you a good idea of what to expect.
Initial Support Coordinator Contact (Same Day)
To get the POC review process rolling, you’ll reach out to your support coordinator. Unless you’re calling at an exceptionally busy time, you should be able to reach them the same day. The goal of this call is to explain that you want to request additional services.
Meeting with Medicaid Provider (Varies)
After you’ve communicated to your support coordinator that you want to request more Medicaid waiver services, they will meet with your Medicaid provider to discuss your POC and any necessary changes. They’ll also fill out your POC revision request form. You may attend this meeting as well in some cases.
The time it takes to align everyone’s schedules may vary. For instance, your medical provider might not be available for a meeting for a week or more. Or they may be available in a couple of days or so. It depends on everyone’s schedule.
LGE Review Process (7 Days)
After the meeting mentioned above, your support coordinator will send the POC revision form to a Local Government Entity (LGE). The LGE will review the form and any accompanying documentation; then, they’ll either approve or deny the request. This takes 7 days max.
Determination Delivered by Support Coordinator (Varies)
After the LGE has completed their review, they’ll send their approval or denial to your support coordinator by mail. Then, the support coordinator will review the LGE’s determination and share it with you. Whether your POC revision request was approved or denied, it could take some time for the support coordinator to get back to you. It depends on their workload, the LGE’s determination, and more.
When Do Your New Services Start After Approval?
Your support coordinator will indicate a preferred service start date on the POC revision request form. The soonest date they can choose is 7 days after the LGE review is complete. But there’s no guarantee that this date will be upheld, especially if there are delays or additional information needed.
Get Help Through Your Support Coordinator
If there are delays or you have questions or concerns, reach out to your support coordinator. They answer questions, contact relevant parties as necessary, and deliver status updates (among other things). They can also inform you of your options if your request for additional services is denied.
