Pat,
This is where things get dicey. As the claim form clearly states, Robin
started 9/16. I sent you several requests at that time for paperwork on her.
I even asked Colleen if you were out. I received no responses from you
whatever.
You’ve previously told me that you needed to be the person to create the
paperwork on new hires. I have never understood the reasoning for that
requirement as I also have copies of the forms, but it hasn’t been a problem
until now. Again, to clearly state the situation, I received no response to
multiple attempts to inform you of a new hire. Since my ability to pay
caregivers is directly dependent on the continued flow of MetLife
reimbursement checks, I could not afford to wait the nearly two months it
has taken to advise you of Robin Jones. My initial email on this matter
clearly stated that 9/15 was Mae Woods’ final day of employment. (She
returned to St. Louis to marry a childhood sweetheart.)
To me, this is a classic example of why MetLife really doesn’t need the
identities of my caregivers. That information has no effect on the amount I
invoice for, and MetLife does not report individual caregiver income to any
other entities. Yes, I’m telling you all invoices after 9/15/05 were
incorrect, but only in that they continued to name M H Woods instead of
Robin Jones. I have to do something like that every time there is an
employee change because it takes you a while to catch up. If I didn’t
continue to report time under the name of the previous employee until you
officially "blessed" the replacement, MetLife would’ve forced me into
bankruptcy years ago by delaying reimbursements. What made this time any
different was just that it took almost two months to get you caught up!
To answer the same question that I did for Colleen yesterday, Robin is paid
roughly 50% of what I bill to you. She works the same hours as Mae used to.
As soon as you officially accept her employment, I will be able to adjust
future invoicing to better reflect reality.
Scott
—–Original Message—–
From: Patricia McCathron [mailto:pmccathron@metlife.com]
Sent: Thursday, November 10, 2005 7:58 AM
To: royall@conchbbs.com
Cc: Colleen R Carswell
Subject: RE: Robin Jones
Scott,
Just let me know when Robin began, how much you pay her and how often she
is there so I can update your plan of care for Colleen to pay. MetLife h as
acknowledged that you prefer to hire your own staff and Colleen needs to
know what you pay them.
Pat
"Scott Royall"
<royall@conchbbs. To:
ccarswell@metlife.com
com> cc: "’Patricia
McCathron’" <pmccathron@metlife.com>, "Blaise"
<Blaise.Mladenka@aliefisd.net>, "Blog"
<adayinthelifeofaperson.Corby@spaces.msn.com>,
11/09/2005 02:21 bradgsmith@mdanderson.org,
"Brandon Milligan" <bsmtechb@yahoo.com>, "Carol McKinney"
PM <Carolm2345@aol.com>,
delon1@juno.com, "Dianne" <fwilliams@houston.rr.com>, "DSloan"
<djsloan25a26@yahoo.com>,
"Jack Davidson" <jack_davidson681@yahoo.com>,
janis.nicol@nau.edu, "John
Royall" <4r@startel.net>, "Mom"
<lourez_bullock@sbcglobal.net>, "RICHARD BECTON" <RBEC@flightoptions.com>,
"Sakina
Lanig"
<lanig2us2001@yahoo.com>, "Tao Ju" <jutao@cs.rice.edu>, "Traci Jackson"
<traciljackson@msn.com>
Subject: RE: Robin Jones
Ok, let’s back up a step so that you can better understand the real
picture. If MetLife was reimbursing a normal care-providing agency, you
still would not necessarily know the names of the employees who actually
provided the care. Those agencies send whoever is available at the time.
That’s why I don’t use agencies. It’s also why it seems odd to me that
MetLife wants to know the names of my current employees. MetLife has no
liability regarding them individually. You certainly don’t prepare their
W-2 data (I wish you did!) so the need to know their identities is a double
standard on the part of your auditors. They surely know that caregiving
agencies have constant employee turnover, and MetLife isn’t bothered with
the gory details of who worked what hours/days. See the different
treatment? I am my care provider of record. I identify my employee info to
you more as a courtesy than anything else. In the strictest sense, it
wouldn’t matter to MetLife if my invoices still showed Jack Davidson and
Anna Fitzgerald as current employees (and yes, Jack still is). It’s Texas
and the Feds who need the straight skinny.
Actually, MetLife used to require two forms per employee. One was a true
Hold Harmless, absolving MetLife of any liability in employment disputes,
that each caregiver had to sign. (That’s what confused me this time.) The
form we now use is really just a claim form saying I will be paying
so-and-so for care. In a way, that implies your auditors have acknowledged
the reality that I will be the payer/invoicer. The third party is really
academic from your company’s vantage point. I’m saying your auditors are
wanting to visually admire their cake even as they finish devouring it.
Now, as to your question, 50% of $869.40 is $434.70. Of course that assumes
an equal share, which I’ve already explained isn’t always true.
From: ccarswell@metlife.com [mailto:ccarswell@metlife.com]
Sent: Wednesday, November 09, 2005 9:37 AM
To: royall@conchbbs.com
Cc: pmccathron@metlife.com
Subject: RE: Robin Jones
Mr. Royall,
Perhaps, I should have worded the request differently. Our new payment
system requires an update of the plan of care and the claim form before a
payment can be generated. Pat needed the number or hours or days per week
for the hold harmless and your plan of care. Since the payment of your
invoices is a claims function I was requested to obtain the information. I
take accountability for the misunderstanding . The very last thing I wanted
to do was to stress you in anyway. Until the invoice is actual received we
have no way of knowing whether your have replaced one of your caregivers or
whether your were merely adding an additional one.
Please accept my sincere apology.
(Embedded image moved to file: pic07245.gif)"Scott Royall"
<royall@conchbbs.com>
(Embed (Embedded image moved to file: (Embedded image moved to
ded pic28564.gif) file: pic31539.gif)
image "Scott Royall"
moved <royall@conchb To: ccarswell@metlife.com
to bs.com> cc: "’Patricia McCathron’"
file: <pmccathron@metlife.com>
pic067 Subject: RE: Robin Jones
02.gif 11/08/2005
) 08:32 PM
Colleen,
This is crap, and you know it. MetLife does not even pay my caregivers, I
do. MetLife merely reimburses me up to the daily maximum allowed, which is
to say I’m partially reimbursed. Remember that those invoices you get are
dubious to start with, because they don’t show the actual costs so what
right does MetLife have to ask the question? None. Your company neither
pays the full cost of my caregivers nor does it accept liability for the
resulting employment taxes (roughly $6,000 annually). Until those facts
change, MetLife has no right to even whisper such a question. Clear?
Yes, I know, you’re just doing as you’re told to by management de jour.
However, it’s essential that Pat and you remember the proper context. The
auditors who dreamed up such questions are still operating under the
outmoded belief that MetLife only pays care providers directly. The three
of us already know that’s not universally true, and it will become even
less true as more and more disabled people have to accept the
responsibility for running their own affairs. For better or worse, MetLife
does not employ my caregivers, I do. Of course that arrangement benefits
both your company and me. MetLife gets to avoid the bulk of
responsibilities and liabilities involved in hiring and managing
caregivers, while I get to retain some semblance of control over my own
life.
In truth, this email is written so you can place it in my file to answer
any such stupid questions in the future. I’ll repeat for you the same thing
I told Rosemary nearly eight years ago. I’m not some brain-dead individual
rotting away in an institution, and you won’t find a time-clock in my
house. That means that the details of the weekly invoices I’m required to
submit are designed to insure sufficient reimbursement to sustain payroll.
We all know that the terms of this particular LTC policy really only
provide for funds sufficient for one eight-hour shift per day. An active
person like me needs full-time support so one of the ways I stretch the
funds is by guaranteeing my caregivers a steady?albeit, low?salary. Of
course factors such as performance cause their salaries to vary. So, as you
can see, I couldn’t answer your auditors even if I was inclined to.
Scott
From: ccarswell@metlife.com [mailto:ccarswell@metlife.com]
Sent: Tuesday, November 08, 2005 2:57 PM
To: Royall@conchbbs.com
Cc: pmccathron@metlife.com
Subject: RE: Robin Jones
Mr. Royall,
I have been advised that the hold harmless paperwork has changed. In order
to properly prepare it, please advise what amount your are contemplating
paying Ms. Jones per week. This additional information is needed to
expedite adding your new caregiver to your Plan of Care.
—– Forwarded by Colleen R Carswell/Ins/MetLife/US on 11/08/2005 03:47 PM
—–
(Embe (Embedded image moved to file: pic02257.gif) (Embedded image
dded "Scott Royall" <royall@conchbbs.com> moved to file:
image pic02370.gif)
moved
to 11/07/2005 02:28 PM To: "’Colleen R
file: Carswell’"
pic02 <ccarswell@metlife.
572.g com>
if) cc: "’Patricia
McCathron’"
<pmccathron@metlife
.com>
Subject: RE: Robin
Jones
Ok Snoopy, here’s a replacement bone.
—–Original Message—–
From: Colleen R Carswell [mailto:ccarswell@metlife.com]
Sent: Monday, November 07, 2005 12:49 PM
To: royall@conchbbs.com
Cc: Patricia McCathron
Subject: RE: Robin Jones
Mr. Royall
For auditing purposes we will accept your mark as the signature. Please
send it.
"Scott Royall"
<royall@conchbbs. To:
ccarswell@metlife.com
com> cc:
Subject: RE: Robin Jones
11/07/2005 01:41
PM
Ok. I forgot mine was the signature needed (ironic since I really don’t
have one that’s legally valid).
From: ccarswell@metlife.com [mailto:ccarswell@metlife.com]
Sent: Monday, November 07, 2005 8:33 AM
To: royall@conchbbs.com
Cc: pmccathron@metlife.com
Subject: Re: Robin Jones
Mr. Royall,
I have received the claim form. As you know Robin can witness the claim
form, but we will need your signature as well.
(Embedded image moved to file: pic04327.gif)"Scott Royall"
<royall@conchbbs.com>
(Embedde (Embedded image moved to file: pic03454.gif) (Embedded image
d image "Scott Royall" moved to file:
moved to <royall@conchbbs.com> pic31896.gif)
file:
pic03413 To:
.gif) 11/05/2005 03:45 PM ccarswell@metlife
.com
cc:
pmccathron@metlif
e.com
Subject: Robin
Jones
Here you go. You probably only needed page 2, but this will keep the
auditors happy.
(Embedded image moved to file: pic12472.jpg)
(Embedded image moved to file: pic24450.gif)
(See attached file: Jones MetLife 2.jpg)(See attached file: Jones MetLife
1.jpg)
The information contained in this message may be CONFIDENTIAL and is for
the intended addressee only. Any unauthorized use, dissemination of the
information, or copying of this message is prohibited. If you are not the
intended addressee, please notify the sender immediately and delete this
message.
The information contained in this message may be CONFIDENTIAL and is for
the
intended addressee only. Any unauthorized use, dissemination of the
information, or copying of this message is prohibited. If you are not the
intended addressee, please notify the sender immediately and delete this
message.(See attached file: Jones MetLife 2.jpg)
The information contained in this message may be CONFIDENTIAL and is for
the intended addressee only. Any unauthorized use, dissemination of the
information, or copying of this message is prohibited. If you are not the
intended addressee, please notify the sender immediately and delete this
message.
The information contained in this message may be CONFIDENTIAL and is for
the intended addressee only. Any unauthorized use, dissemination of the
information, or copying of this message is prohibited. If you are not the
intended addressee, please notify the sender immediately and delete this
message.
The information contained in this message may be CONFIDENTIAL and is for the
intended addressee only. Any unauthorized use, dissemination of the
information, or copying of this message is prohibited. If you are not the
intended addressee, please notify the sender immediately and delete this
message.
Disability in America 