Saturday, November 28, 2009

Tennessee autism service provider has to stop offering in-home service due to state's lack of payment

From WJHL-TV in Kingsport, Tenn.:

Rob Chittum says he and his wife cannot risk waiting any longer for the state to pay them for their services. The Chittums own Behavior Solutions, a TennCare-approved health care provider that offers its services to kids with autism. Last month, Behavior Solutions stopped offering its TennCare-funded in-home service to clients.

“It was a very hard decision because individuals we work with really need the service,” Chittum said.

Although stopping those visits wasn’t easy, Chittum says after spending the last two months waiting for his payments, he had no choice but to call it quits.

“After fighting with this for a year-and-a-half, it was just too much to continue,” he said. “Currently, we’re owed about $1,000.”

TennCare contracts with several private insurance companies to manage this type of care (Applied Behavior Analysis). A handful of Northeast Tennessee providers (Appalachian Behavior Support Service, Joe Darling, MS, and Lighthouse Independent Living) say the last year has been quite the challenge.

At one point, Chittum says he and his wife waited four months for more than $5,000.

“That entire time, we’ve had trouble getting payment,” Chittum said. “You have to stay on top of it; call every day or several times a week and still have trouble getting payment.“

Although the delay in payments is costing providers money, they fear children with autism will suffer the most. Gen Baldwin will tell you that first-hand. For months, Baldwin had some extra help taking care of her 16 year-old son. Twice a week, Chittum would come into her home and work with Nathaniel.

“It changed his whole quality of life,” Baldwin said. “I take Nathaniel to the grocery store now. I can take Nathaniel to festivals to listen to music again.“

According to Baldwin, her son made great strides during Chittum’s visits. However, when Chittum had to stop his services last month, Baldwin says Nathaniel (pictured) noticed.

“It’s all starting to spiral back out of control,” she said. “His destructive behaviors have increased. His aggression towards others has increased. His obsessive-compulsive behaviors have increased.“

The Bureau of TennCare is aware of the problem when it comes to delays in payments. The agency urges any providers with concerns to call the TennCare Providers Services Line at (800) 852-2683.

“Once we were first notified of the payment issues, we worked closely with our (Managed Care Organizations) to enact a plan and what we’ve done since that time, we’ve actually outreached to all of our behavioral health providers,” TennCare Communications Manager Carol Fite said. “Our (MCO’s) are working quickly to try to issue any payment or resolve any problems that they’re having at this point and I’m very confident that that will happen.”

Blue Cross-Blue Shield of Tennessee, the insurance company responsible for managing Chittum’s account, assures Chittum a check is in the mail. Media Relations Manager Mary Thompson says the company mailed Chittum a check for the correct amount today.

“Our providers are very important to us, “Thompson said. “As always, our focus is on ensuring that they receive payment for the important services they provide our TennCare members.”

Still, that check may be too little, too late. Chittum admits he may be finished working with TennCare members who suffer from autism for good. And he fears he may not be the only one.

“The individuals being served are the ones losing out,” Chittum said. “This is not a little thing for families.”