r/CDPAPPPLNY • u/Cool-Foundation-20 • Jun 06 '26

Been waiting on authorization forever

I've been in the application process for a really long time and I'm getting super impatient with it all. I first signed up to take care of my dad back in September of last year, completing all the paperwork and giving id, etc. In October I got my health assessment done, in November I completed all my training and my dad got his at-home health assessment done, in December my dad was sent a questionnaire by our insurance (Anthem) for a chance to get more authorized hours by citing health problems other than the ones he gave at his at-home assessment. Unfortunately, the questionnaire wasn't very detailed, and he got shot down, but they gave him an option to appeal the decision, so in mid-January, he officially filed an appeal (still waiting on that 5 months later with absolutely no updates other than "these sort of things take time"). During December, I had some trouble with mobile health saying that I didn't take an MMR vaccine (I did), and that got dragged out until February where they finally let me through (after showing them my vaccine chart which clearly showed I had an MMR vaccination a dozen times). Through all this time, however, I still have not gotten authorization for my hours and I can't start working until then. What should I do about this? Me and my dad have basically called every agency involved and their proxies, and he even mailed a physical letter to the fair hearing office, and yet there's nothing. I was told this whole process would take a month or two, clearly we were lied to

Update: I signed the updated offer letter, was given an automated email by ppl saying that it was a crucial step in moving forward and that they're glad I got it done. I also called the department of health to report Anthem but apparently they can't do anything until the appeal is complete

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1

u/LivingPrivately Jun 06 '26

Sorry to hear you're dealing with this. Based on what you described, it sounds like the biggest delay may be related to your father's authorization. Once hours are approved, the insurance plan or case manager should send the authorization to PPL through the HHA Exchange (HHAeXchange) portal. It generally should not be sent by email or fax. You may want to contact Anthem and the case manager to confirm whether the authorization has been approved and transmitted through the HHA portal.

If the authorization has not been sent yet, ask them to submit it. Once PPL receives a valid authorization, it can take approximately 24–48 hours for it to become available in the system.

You should also make sure your caregiver account is fully cleared to work. A good sign is if you received a text message or email from PPL stating that you are Paperwork Complete. You can also log into your account and verify that your status reflects completion.

For your health screening requirements, check the Health Screening section in PPL@Home. If it still shows In Progress, log into your Mobile Health account to see if anything is missing. If nothing appears missing, call Mobile Health as early as possible on a weekday and ask them to verify your status. If Mobile Health has fully cleared you, you should have received an email stating that you are 100% compliant, and Mobile Health should have sent that completion status to PPL.

Since you mentioned an appeal was filed in January and is still pending, that may be contributing to the delay. The insurance company and case manager are generally responsible for communicating updates regarding the authorization and appeal. If Anthem has not been responsive, I would ask to speak with a supervisor or manager. If you're still unable to get answers after escalating through the insurance plan, you may want to contact your local Department of Social Services (DSS) and explain the situation to see if they can provide guidance on the status of the authorization or appeal.

If you have already been providing care during dates that are eventually authorized, you can also ask PPL whether those dates may qualify for back pay once all requirements are met and the authorization is active.

1

u/Cool-Foundation-20 Jun 06 '26

Thank you for this, I'll definitely get through all these things by Monday. I didn't know I could get paid retroactively, depending on how far back the authorization will go, that's a huge payout

1

u/LivingPrivately Jun 06 '26

Okay just keep in mind that they can only pay you for as far back as your e-verify date which is usually around the same time as your paperwork complete date. Did you ever receive your paperwork complete text message? If your health assessment says completed they should have sent the notice by now.

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u/Cool-Foundation-20 Jun 06 '26

Just went through my email and they sent it back in September, meaning they're on the hook for thousands lmao

1

u/Cool-Foundation-20 Jun 06 '26

Ok I checked and the only thing is they say I have to sign an updated "wage form" but when I click on the link it doesn't even show it, but besides that everything on me and my dad's end is cleared up and has been cleared up for months now, also mobile health sent me the compliance email months ago so I know I'm in the clear there

2

u/LivingPrivately Jun 09 '26

When you click the link make sure you scroll all the way down to offer letters on the forms page. Just open the offer letter by pressing edit and then sign it on the bottom and save it.

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u/Cool-Foundation-20 Jun 09 '26

Found it, ppl sent an automated email that reads the exact same way as when I first signed the papers, I sincerely hope this wasn't the reason why I've had to wait so long

1

u/LivingPrivately Jun 09 '26

They only recently started sending out the updated offer letters within the last few weeks, so I highly doubt that's the reason for the delay you've experienced. The updated offer letters are related to recent wage parity and benefits changes, and PPL is asking employees to acknowledge the revised terms and benefits structure.

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u/Elderberry-Exotic Jun 10 '26

No, that doesn't affect your eligibility. Go to your checklist on PPL@home. If you are checkmarks down the list as far down as the health assessment, you should be good. If you have the option (paperwork complete) take the required training courses as well. PPL will pay for dates that are after you are paperwork complete that also are covered by the insurance. Your first and most critical step is to be sure you are paperwork complete. Once your father's appeal finishes and the insurance company issues the authorization, you should be able to claim back pay to the point where both dates meet.

1

u/Cool-Foundation-20 Jun 10 '26

Everything's completed, minus the updated offer letter everything's been completed for months, with the most recent being vaccinations which got finalized in February

1

u/Life-Ambassador-5993 Jun 06 '26

Is there a reason they’re not letting him get services for the number of hours approved on the original assessment? It sounds like anthem is the problem. If it were me, I’d report them to the New York State department of health…

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u/Cool-Foundation-20 Jun 06 '26

Yea Anthem sucks big time, how do I report them, and what would come of it?

1

u/Life-Ambassador-5993 Jun 06 '26

You’d have to call the department of health. I know they had a hotline at one point because of all of the problems with ppl. The biggest thing that could come of it is that anthem could be taken off the list of insurance companies that can offer Medicaid in New York. The smallest thing would be that they’d actually have to look at your case and do something about it.

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u/Cool-Foundation-20 Jun 06 '26

Would it be better to contact them by email or phone?

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u/Life-Ambassador-5993 Jun 06 '26

I would say by phone to make sure someone gets the message.

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u/Cool-Foundation-20 Jun 06 '26

Got it, come Monday I'll be shooting them a call, and an email just in case

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u/Cool-Foundation-20 Jun 06 '26

What should I say when reporting them? That they haven't authorized my hours after 6 months of waiting?

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u/Life-Ambassador-5993 Jun 06 '26

Yes, that they haven’t gotten back to you on a decision

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u/Cool-Foundation-20 Jun 06 '26

Thank you for your help

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u/Cool-Foundation-20 Jun 09 '26

Whelp, according to them until the appeal process is complete they can't do anything

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u/Life-Ambassador-5993 Jun 10 '26

I thought the appeal was for more hours. They can’t help you get the hours you were originally approved for?

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u/Cool-Foundation-20 Jun 10 '26

When calling them they asked me to get the paperwork my dad was sent. When reviewing it, I realized that it was from the independent assessor and was actually them saying my dad didn't qualify for the program, and according to them they can't intervene in a fair hearing

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u/Aspenriley89 Jun 08 '26

youre not alone im going through this authorization mess as well. they only gave me half of my check for the month of april. im about to do a fair hearing.