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Guest
Columnist – Joseph L. Roman, Esq., Law Offices of Joseph
L. Romano, Esq., Norristown, PA
Below
are some suggestions on obtaining funding from various sources
following a traumatic brain injury
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Did
you obtain your Master Health Insurance Contract or Master Provider
Agreement, and Treatment or Practice Guidelines from your health
insurer? |
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Are
you aware of your appellate health insurance rights? What are
the time limits...are there internal/external appeals and grievance
procedures? |
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Obtain
from your insurance company, in writing, the specific reasons
for the denial of treatment services. |
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Provide
your health insurer the requested health insurance records,
but never give the health insurer unlimited access to attend
team meetings and treatment sessions, or to talk with your treating
doctor, unless a family representative or advocate is present. |
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Don't
let your health insurer or worker's compensation carrier "box
you in..." You control your medical and rehabilitation
alternatives...they don't! |
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Do
you have written IEP (individualized Educational Program)? Is
your child receiving all aavailable TBI benefits from your school
district? |
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Are
you coordinating all of your available benefits: private health
insurance benefits, governmental benefits, special education
benefits, DVR (Division of Vocational Rehabilitation) benefits,
waiver benefits, estate planning benefits and potential recoveries
from a third party lawsuit? |
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Have
you done a prompt, thorough investigation to the determine the
cause of your TBI? Automobile, worker's compensation, product
liability, recreational accidents and other negligence investigations
should be pursued in order to insure a permanent/long-term funding
alternative to governmental benefits. |
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Consult
an attorney to prepare your Will, Durable Power of Attorney/Springing
Power of Attorney, Living Will and estate planning documents
(special needs trust, etc.) |
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Are
you a squeaky wheel? Be aggressive, be vigilant, be creative,
"think outside the box" in knowing your legal rights
and protecting your rights!! |
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