Retrospective claim for CH fees

Discussion in 'Legal and financial issues' started by LYN T, Apr 16, 2015.

  1. LYN T

    LYN T Registered User

    Aug 30, 2012
    6,962
    Brixham Devon
    My late Husband was self funding for 26 weeks before he was awarded CHC at the end of Dec 2013. Of course, I put in a retrospective claim for the 6 months he paid. The CCG collected the very comprehensive records from the CH 9 months after the CHC was given:eek:This was after the CH Manager had phoned at least 5 times asking them to collect:confused: Why so long? No idea. For the last month I have phoned them every week asking for a decision. The team dealing with the claim repeated changed their story as to how far it had advanced. Eventually I asked to be put in touch with the 'Designated Complaints Dept'!!!!!!

    Yesterday I received a letter from them which started that I would be refunded 16 weeks and 3 days. Apparently, on 02/09/2013 Pete wasn't eligible but 03/09/2013 he was:confused:

    Next battle; I very stupidly sent them all of the CH invoices and didn't make copies of them. I should have known they would lose them (sent recorded delivery). I have a copy of a statement sent to me by the CH Manager which states the costs of the care etc. I feel another battle on my hands to get the refund. Then I have to make a decision as to whether I should fight for the other 9 weeks and 4 days to be refunded.

    You couldn't make it up if you tried:eek::rolleyes:

    They sure try to grind you down!

    I hope your days haven't been too bad so far.

    Lyn T XX
     
  2. jenniferpa

    jenniferpa Volunteer Moderator

    Jun 27, 2006
    39,438
    Have you asked the CH if they could reprint the invoices? I bet they still have them on their system.
     
  3. nitram

    nitram Registered User

    Apr 6, 2011
    19,254
    Male
    North Manchester
    From whom are you claiming the care fees?

    When I got my wife's CHC backdated I got a refund from the nursing home.

    I emailed their head office with copy to local management saying that retrospectively from <date> the contract was with the CCG who were therefore responsible for all fees thereafter and asking for all fees I had paid from that date to be refunded.
     
  4. LYN T

    LYN T Registered User

    Aug 30, 2012
    6,962
    Brixham Devon
    Interesting Nitram

    I have phoned the CCG and they are definitely the ones doing the refunding to me.After a rather fraught phone conversation today I have pointed out that they had acknowledged the receipt of the statement and the invoices. Where they have 'filed' them is not my problem:) I have also sent them a letter stating they will have to go by the statement which clearly shows what I've paid.

    Jennifer-I may have to take this route but I will have to ask the CH owner; the Carers/manager are lovely people but I'm afraid the owner is let's say very keen to get the money off residents but not so keen to be helpful.

    I mentioned in my letter that I would be phoning them next week to get an update on the progress. Oh dear!
     
  5. nitram

    nitram Registered User

    Apr 6, 2011
    19,254
    Male
    North Manchester
    As soon as the CCG (actually PCT) informed me I put the request in to the home as it seemed the easiest and quickest way for me to get the refund.

    I was paying x and the NHS were paying FNC, this changed to the NHS paying their tariff fee of y where y is less than x. Getting the refund from the home just left the PCT and the home to sort things out.
     
  6. LYN T

    LYN T Registered User

    Aug 30, 2012
    6,962
    Brixham Devon
    Update! Well I sent a bank statement showing payments and the CH owner sent copy invoices (received by CCG 30/4/2015) thanks for that suggestion Jennifer PA. So all paperwork received by the CCG. Still no payment (or even letter for me to sign in which they have worked out how much they should repay), I have phoned once a week every week. Have been told various reasons for delay -from my Husband is dead so they deal with refunds for people who are alive first:eek:to today when they said they are missing a bit of internal mail (nothing to do with me)

    Now fed up-I've sent an email to the CCG complaints dept. It will be interesting to read what they have to say, especially as I've pointed them in the direction of the NHS guidelines for retrospective CHC redress (it says repayment shouldn't be delayed):confused:;)

    Oh well! Life is all about fighting isn't it:D:rolleyes:

    Hope your days have been as good as possible

    Lyn T XX
     
  7. Saffie

    Saffie Registered User

    Mar 26, 2011
    22,498
    Female
    Near Southampton
    I've still not heard anything since I rang the CCG last September to ask what happens to the postponed full DST assessment meeting from 6th May!
    Were they aware my husband had since died?
    Yes they were. Very sorry.
    So should I have heard from them regarding his death?
    Yes I should have done. Very sorry.
    So would there still be a meeting abouth his entitlement to CHC?
    Oh yes, but it would go straight to the panel.
    When?
    I should hear in a week!!!
    Still waiting. Not sure I have the energy or determination to go further on such a lost cause!

    I admire your spirit and determination Lyn.
    Just don't hold your breath - you'll go blue! x
     
  8. LYN T

    LYN T Registered User

    Aug 30, 2012
    6,962
    Brixham Devon
    Ha! I would have been grateful if 'they' had expressed any condolences that Pete had died. It was almost like there was a delay because Pete had passed and it was his fault. I had been feeling sorry for them as they must be inundated by the paperwork-but really is it my fault? Is it Pete's fault? Is it your fault? Dave's? NO, NO, NO, and NO!!!

    It is so draining I can really understand why people don't ever try to get CHC funding let alone retrospective:mad:

    Watch this space.

    Thinking of you Saffie as you approach the anniversary of Dave's passing.

    Love

    Lyn T XX
     
  9. nitram

    nitram Registered User

    Apr 6, 2011
    19,254
    Male
    North Manchester
    "Watch this space."

    Go get em!

    16 weeks 3 days of care fees is a fair hunk of cash.
    Who's got it, care home or CCG?
    It's not theirs, it's yours and has been for some time, start talking interest.
     
  10. LYN T

    LYN T Registered User

    Aug 30, 2012
    6,962
    Brixham Devon
    I've no idea who's got it:confused: I have been told by the ONE person who has shown any sense that I will get interest as it's been over a year! Still trying to fight/be feisty;) Have to say that's not natural for me! But even I'm riled!

    Thank you

    Lyn T X
     
  11. nitram

    nitram Registered User

    Apr 6, 2011
    19,254
    Male
    North Manchester
    "Still trying to fight/be feisty Have to say that's not natural for me! But even I'm riled!"

    OK , if you feel up to it approach the care home and in effect say ' I gave you money when I should not have. Can I have it back with interest please?'.

    This is nothing to do with the quality of care that was provided or the staff that provided it, it's just the fact that the CCG took over the contract retrospectively and the fees should have been paid by them.

    I'd be interested in their reply.
     
  12. LYN T

    LYN T Registered User

    Aug 30, 2012
    6,962
    Brixham Devon
    The one (only one) person who was proficient at her job said she would phone me next week-she does the calculation/interest-. I wish I had gone with your original suggestion to approach the CH for redress! Oh well! We live and learn. I'm a bit spineless at times:eek:

    Lyn T XX
     
  13. nitram

    nitram Registered User

    Apr 6, 2011
    19,254
    Male
    North Manchester
    The problem is that the money for you is actual money, for the other parties it's just playing around with balance sheets, try to convince them of this.
     
  14. LYN T

    LYN T Registered User

    Aug 30, 2012
    6,962
    Brixham Devon
    Well progress of sorts! The 'helpful' lady didn't phone as had been promised (I really thought she would so I was a bit disappointed) However, she has phoned today and said a recorded delivery letter would be sent to me today with the amount/interest the CCG are paying. I think she may have only made contact because I emailed a Notice of intent to the ccg complaints dept stating I would start court proceedings unless they paid me X plus interest within 14 days. (got the wording/info off the net:D)

    I'm getting very cynical in my old age-and I don't like it:eek:
     
  15. Saffie

    Saffie Registered User

    Mar 26, 2011
    22,498
    Female
    Near Southampton
    Well done Lyn. I hope it arrives pronto.x
     

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