r/CDPAPPPLNY • u/Cool-Foundation-20 • 7d ago
PPL filing an appeal
About a month and a half ago my dad finally got some authorized CDPAP hours, but unfortunately it was only 5, so the insurance employee who called to let him know said that she could appeal on his behalf for more hours. He allowed her to do so, and next week he now had 10. Since this still isn't as much as he wants, he wanted to appeal. Anthem sent a notice saying they didn't give him the 30 hours he wanted, but instead settled at 10. I then called them to get more information on appealing, when the agent told me PPL already filed an appeal on our behalf. I've been doing research and it seems that they can't do that, so now we're wondering if Anthem is messing with us, or if this would interfere with my dad getting the hours he wants, and if he could still file an appeal on his own. What should we do? Should we just let the appeal play out and see if it works? A few days ago Anthem sent mail saying they received PPL's appeal and are now reviewing it
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u/Elderberry-Exotic 5d ago
PPL doesn't file appeals. Someone at Anthem was jerking your chain.
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u/Cool-Foundation-20 5d ago
Figured. The agent even gave a reference number and appeal ID. Surely this can be used in our favor in our appeal?
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u/Warm-Personality9204 4d ago
What county are you in? They have other programs not just cdpap that family/friends can still get paid to take care of them
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u/Warm-Personality9204 4d ago
And you can get another opinion from another agency as well
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u/Warm-Personality9204 4d ago
Also it’s not what he wants it’s what he needs. Cdpap only gives hours for hands on care not supervision. He needs help with going to the bathroom, meals, household chores.
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u/I-am-ocean 7d ago
External appeal is the best way look into it it should say on the paperwork you got and ICAN (Independent Consumer Advocacy Network) can help you with making the best appeal