Trillium Health Resources

Reviews about Trillium Health Resources

• pallet umsted

  Apr, 11 2018
  ★ ☆ ☆ ☆ ☆
  Trillium Health Resources came to Nash County NC assuming MCO duties effective 7-1-17. Trillium then systematically began reducing approved through home and community based services from the previous MCO, mostreductions, denials and partial denials RETROACTIVE to 7-1-17.
  
  Home and community based MUST be medically necessary, must have medical supporting documentation and must MEET THE INDIVIDUAL NEEDS OF THE INNOVATIONS WAIVER CLIENT. Clients with approved ISPs and ISP Budgets HAD MET THIS REQUIREMENT.
  
  Trillium then denied Respite for many Nash County Innovations Waiver clients on a group basis, not with INDIVIDUAL considerations, in violation of 1915c guidelines and the State Plan.
  
  Trillium then pressured, requested, RE-requested parents and guardians to execute a Revision to their approved ISP because the TAR Form was incorrectly generated by the Provider? AND, per Trillium, Eastpointe had not written a goal for Respite in the ISP. Trillium employees stated they were aware a goal was NOT written PRIOR TO their 7-1-17 takeover. These administrative functions were known by Trillium PRIOR TO the Nash County takeover. In our case, it is noted the TAR Form was generated 5-24-17.
  
  Let's Wainwright acknowledged Trillium, her company also did not have, or was not accessing documents (see Rocky Mount Telegram) because Eastpointe did not give them to Trillium.
  
  Trillium retroactively took Adverse Action on approved home and community based services despite NOT PURSUING THE PERTINENT AND RELEVANT DOCUMENTATION SUBMITTED TO EASTPOINTE.
  
  What is the advantage to Trillium to NOT reviewing, not retrieving, not assessing submitted supporting medical documentation for current home and community based services? You have no evidence to support medical necessity for that individual clients need. A denied service is supported.
  
  These processes are prohibited.
  
  Contact DISABILITY RIGHTS OF NC.

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