APPLETON, WI — A Fox Valley home health care provider is fighting Medicaid claims that they owe tens of thousand of dollars.
And they’re taking their case to court this week, hoping to make the “business” of health care clearer for others.
Compassionate Home Health Care’s CEO says Medicaid claims the not-for-profit billed them for back-to-back travel time to the tune of $28,000.
They’re claims she says they have the paperwork to prove wrong.
Dawn Paradiso-Hansen says her team is driven to keep those with living challenges in their homes longer.
“And they have a compassion to help people,” adds Paradiso-Hansen, outside of the meeting room in Outagamie Co. court Thursday.
But 3 and 1/2 years ago, an audit uncovered what the Department of Health Services considered discrepancies in clients’ medical orders.
“The medical orders that they claim are incomplete actually are complete,” adds Paradiso-Hansen. “They approved them.”
When the State gave her a final offer for settlement, Paradiso-Hansen gave them a court date.
She says she’ll be the first to admit there was confusion on her company’s part about the “most appropriate” way to keep records. However, Paradiso-Hansen says numerous attempts to obtain more clarity on the issues weren’t reciprocated by Medicaid.
“We made mistakes, we made some errors. They made errors, as well,” says Paradiso-Hansen, “in their oversight.”
She also put together a team of accounting interns who’ve spent countless hours gathering 10,000 documents of proof.
“What they were able to pull together in 3 ½ months to show that we have probably 90% of what they say we don’t have, the state couldn’t figure out in 3 ½ years,” says Paradiso-Hansen.
Tammi Mitchell is one of those interns, and agrees that the months-long process has included “a lot of paperwork.”
Fellow intern Rikki Graf says the painstaking process included “a lot of sorting, and knowing what you’re looking for,” which she adds wasn’t always easy.
But Medicaid’s response in court today wasn’t what Paradiso-Hansen was hoping for.
Medicaid’s representatives claim that her team still has a “lack of travel time documentation, and lack of medical orders,” says Paradiso-Hansen.
“This is all the documentation,” assures Mitchell, “there’s nothing left. How can we not have enough?”
No matter what happens, Paradiso-Hansen says she hopes this case will spur change on a state level, making the process of starting, and operating a health care providing company, much clearer.
“How can I learn from it?” asks Paradiso-Hansen. “How can we all learn from it?”
Paradiso-Hansen says a judge will decide the fate of this case within 30 days.
Medicaid spokespeople declined to comment.