What can I do if I suspect fraud and abuse?
Call HOME’s compliance officer at 801-587-3108 or 801-587-3109. You don't even have to tell us your name if you don't want to.
Is the HOME Program a residential service?
No. The HOME Program is an outpatient clinic. Because we provide several services in one location and coordinate your care, we are referred to as a medical “home”. Our name HOME stands for Healthy Outcomes, Medical Excellence.
Can I keep my current primary care doctor?
No. The HOME Program is a coordinated care model where primary care and mental health care are delivered together. To be in the program, enrollees must receive both primary care and mental health care in our clinic.
Does the client/patient need to attend visits?
Yes. Medicare and Medicaid require that patients attend appointments for billing purposes. There are rare occasions where this can be waived but only when specific arrangements are made with your clinician ahead of time.
How often does the client/patient need to be seen in clinic?
The frequency that a patient needs to be seen in clinic varies depending on their needs. We like to see all patients a minimum of once a year for an annual physical exam, and twice a year with a mental health provider. This is to make sure we stay current on how the person is doing and to help with small problems before they become major challenges.
We like to see people with significant challenges more often. For example, someone with uncontrolled diabetes or significant mental health problems will be seen much more often than someone who is relatively stable.
Who do I talk to at the HOME Program?
Your primary contact person in the clinic is your case manager (assigned per last name of the alphabet). You will speak with your case manager with any questions you may have for your providers or regarding challenges you are having. They may call you to get updates on your health status to keep your doctors informed.
Providers are unable to take direct phone calls as they are seeing other patients. You should call the front desk for scheduling or medical record questions. You should talk to your doctor’s medical assistant regarding medication refills, durable medical equipment, home health, lab orders and results, and referrals to specialists.
Will my HOME clinic case manager be my contact for all issues?
No. There will be issues that you will be directed to contact your DSPD support coordinator or other responsible people. Your support coordinator, if you have DSPD services, should be your first contact for school, work, residential, and support staff issues. Our clinic case managers can also work with your support coordinators or other supports regarding these issues.
Who do I contact in a crisis situation?
- Life Threatening Emergencies: Dial 911 or go to the nearest hospital emergency department.
- Non Life-Threatening Emergencies DURING office hours: Call 801-581-5515 and ask to speak to your case manager. Your case manager will gather information and then coordinate with the clinic treatment team or provide instructions on how you should proceed.
- Non Life-Threatening Emergencies AFTER office hours: Call 801-583-2500 where you will speak to the front desk staff at the University Neuropsychiatric Institute. Please tell them you are a member of the Neurobehavior HOME Program, and they will direct your call to the appropriate provider to address your concerns.
What is the HOME Program’s role if a client/patient is hospitalized?
If a patient is hospitalized, please contact your HOME Program case manager. The case manager will notify your HOME Program providers, and if necessary, help coordinate care with the treatment team at the hospital. The case manager will also coordinate any additional follow up appointments needed at the HOME Program once the patient is discharged from the hospital.
How does the HOME Program address medication changes?
In order for your doctor to assess how the medication is affecting the patient, they usually change only one medication at a time. This helps them to target the therapeutic dose of the medication and/or determine if the specific medication is the cause of the adverse effects the patient is experiencing or if the medication is helping to improve the patient’s symptoms.
How can I find out about upcoming activities, groups, or events?
Visit our website or give us your email address so we can send you electronic notices. Watch for flyers and notices at the clinic, and you can also contact your case manager or talk with your clinician about events.
Can I get behavior support from the HOME Program?
Behavior support services can be provided by a HOME behaviorist but can only be paid for through your DSPD funding. We are able to offer limited behavior services on a consultation basis.
Can I change my doctor or therapist within the HOME Program?
Yes. We recognize that a personality fit may not be right; therefore, our policy allows one change in therapist and one change in doctor. HOME will not allow changes in doctor or therapist beyond this. Talk to your case manager if you think you need a change.
What if I cannot make it to an appointment?
It is important that you call us with as much notice as possible to reschedule your appointment. If you do not call us, we are unable to use that time to see other people waiting for appointments. Repeated no shows can result in disenrollment from the program.
What is expected of me or my caretakers?
- If your clinician has asked you to track data on specific things like aggression, sleeping habits, eating habits, and blood sugars, please bring this information to your visits.
- Come to your appointments on time or call and cancel ahead of time.
- Be respectful to all staff and doctors at the HOME Program.
- Always make follow-up appointments on the schedule asked by your clinician.
Will my doctor write letters in support of things I need?
We are happy to advocate for things we believe are in the best interest of our patients. This often means that we need to know the person for some time before we write such letters. It also means that we offer our professional opinion rather than make demands.
Can I get help with school issues?
Yes. Your case manager may be able to attend IEP meetings with you as a support from the clinic, to offer general recommendations of your clinical team, and to be another set of eyes and ears during the process. As with letter writing, we are able to help advocate and give our opinions and recommendations. We do not have the authority to demand school services or determine things like placement.
Can HOME get me into DSPD services?
No. As above, we can help advocate for things we believe will be helpful, but DSPD has control over how they allocate their services.
Fraud is when a person does something on purpose so that the person gets something he or she shouldn't. If a person tries to get health care from a doctor by using another person's HOME Medicaid card, that is one type of fraud. Another type of fraud is if a doctor bills HOME on purpose for a service that wasn't done.
Abuse is when a person does something that costs HOME or the Medicaid program extra money. If a HOME member goes to the emergency room when it isn't really an emergency, that is one type of abuse. Another type of abuse is when a doctor does more services than the patient needs. What can I do to stop fraud and abuse?
- Do not give your ID number to anyone except your doctor or provider.
- Do not ask your doctor or other provider for health care that you do not need.
- If you are offered free health care in exchange for your ID card number, call the HOME Program.
- If someone says they know how to make HOME pay for health care that we do not pay for, please call us.
- Do not let anyone use your ID card.
- Call us if a provider tries to make you pay for your care (except for your co-pay if you have one).