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Medicaid: Forms An Analyst May Ask You To Complete (Supplemental Questionnaires)

Tips For Completing Questionnaires Concerning Your Medical Condition

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Don't delay.

Start working on the forms as soon as you receive them so you won't have to rush to get them returned.

Be very specific.

Be very specific in your answers and include as many anecdotes and details as possible that illustrate how your condition affects your daily activities. Your Work Journal and Symptoms List may be helpful with completing these questions.

Use bad days.

Complete the forms based on your bad days.

Complete the forms yourself.

Medicaid prefers that you complete all forms yourself, no matter how messy that would make a form.

If you cannot complete the form, ask the person who completes it for you to mention on the form that he or she completed it and to state why you were unable to complete the form yourself. For example, the person could write "I, Glenn Fleming, completed this form for Lenore. Lenore was unable to complete this form because of tremors caused by her medical condition."

Write legibly.

It is only important that your answers be legible -- not that they are neat. While you don't want to intentionally mess up the form, analysts say that they can tell a lot about a person's condition by the way the forms are completed.

If your form is professionally neat, explain why.

If your forms are especially neat or typed so they look almost professional, explain why and how long it took to get your forms that way. For Example: This is my fourth draft of this form and it took four and a half hours to do it.

Use additional sheets if necessary.

Add additional sheets if necessary to explain everything thoroughly.

Each additional sheet should be numbered, and should include your name and Social Security number in case the pages get separated.

It should also be clear what question is being answered. Even repeat the question if necessary so it's clear what you are answering.

Talk with friends, family and co-workers you list.

If you list anyone as a source to confirm any aspect of your medical condition and/or the impact on your work or daily life, make sure you tell the person to expect to hear from Medicaid.

Consider having a discussion with each of the people you name to remind them of your symptoms and how each symptom has impacted your work or daily life.

Ask all your medical providers to contact you should they receive an inquiry from Medicaid.

Some physicians will permit your input in the completion of the forms.

Provide your primary doctor and specialist with copies of all your Medicaid forms so they will know what you have said.

After completing a questionnaire, do not submit it right away.

  • Think about it for a day or two as you go about your routine. You may suddenly discover you're in the midst of accommodating a symptom and didn't realize it. Some of your symptoms may have been with you so long, and you have accommodated to them so well, that you forgot they are symptoms. These are the ones that will come to you as you set the form aside and continue with your regular activities for another day or two.
  • Ask a friend, housemate, former co-worker or counselor who is aware of your condition to review the form to see if there are things you may have overlooked.
  • After a few days, review the questionnaire. Re-reading it will probably trigger other issues to be included.

Make photocopies of everything you submit.

Or make sure the Medicaid worker or analyst makes a copy and gives you back the original.

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