Ms. Leavell is a mom of four in Nashville, Tennessee. When Ms. Leavell was pregnant with her 4th child, Elijah, she was on TennCare and knew that this meant Elijah should be automatically enrolled in TennCare as soon as his birth was reported. After Elijah was born, Ms. Levell brought Elijah to his one-month checkup to make sure all was well, and he was a happy and healthy baby. Around this time, his hospital also notified TennCare of his birth and the family’s updated address.
Six months passed and Ms. Leavell brought him to his six-month checkup with his pediatrician. However, the office turned her away because there was an outstanding bill from Elijah’s one month checkup. Ms. Leavell could not pay the bill and Elijah had to miss his six-month appointment. Ms. Leavell was confused why TennCare did not cover Elijah’s one-month checkup and promptly called TennCare Connect to explain the situation. The TennCare Connect representative informed her that a notice was sent to her showing that Elijah’s start date was set at a month after his birth. Ms. Leavell filed an appeal explaining that Elijah’s start date was incorrect and that she had not received any notices from TennCare for months. One week later, TennCare closed her appeal without a hearing stating that it was “too late to appeal this problem.”
Ms. Leavell then contacted Tennessee Justice Center. TJC discovered that notices were being sent to Ms. Leavell’s old address and that TennCare had not updated her address. TJC assisted Ms. Leavell in reopening her appeal and defended the family’s right to a hearing. A week later, TennCare resolved Ms. Leavell’s appeal in her favor. Ms. Leavell was able to get Elijah’s coverage back and get his bill paid for.
Ms. Leavell learned that a lot of mothers were experiencing this issue for their newborns. She was also surprised that she could not get help from TennCare without TJC’s assistance. Ms. Leavell agreed to be a part of TJC’s lawsuit, AMC v. Smith and is hopeful that this lawsuit will protect other TennCare members’ rights. Elijah is now an energetic and healthy 1-year-old.
Photo Credit: Fran Cliff