APPROVED BY CHS-MANITOBA CHAPTER BOARD OF DIRECTORS
Please note – the information contained herein is subject to change.
Please contact the Chapter office for details.
PREAMBLE
Client Services are available to people registered as members of the CHS-MB Chapter and cared for at the Bleeding Disorders Clinic in Winnipeg. Please note that some services are available only to members who meet specific criteria. Please call the Chapter for any clarification.
A completed membership application form must be on file at the Chapter office to be eligible for any and all services. Members, who are listed under their family membership form, need to fill out an individual application, once they turn 18 years of age.
The policy outlined below is designed to help Chapter members find the assistance they need, and guide the Client Services Committee and the Board of Directors as they attempt to balance the needs of members and their families with the limited resources that are available. Misuse of Client Services may result in suspension of privileges.
POLICY
Client Services will help to defray expenses to our members that are related to hemophilia, its complications, and recommended for treatment by the member’s physician.
CHS-Manitoba Chapter will cover only those expenses that have been pre-approved by Client Services, Psychological Services or the Board, in writing. The member is liable for all other expenses. In an emergency, members may apply for reimbursement after services received if the request is submitted to the Committee with proper documentation.
CHS-Manitoba Chapter will not cover expenses that other agencies or plans cover. Decisions of the Board of Directors, or its designated committees, are final.
APPEALS POLICY
The Client Services Committee will consider appeals only if more information is made available. Appeals will be accepted in written form and may be presented in person. The Appeals Board will consist of at least three members of the Client Services Committee. Appeals will be heard within no more than thirty days.
PROCEDURES
All requests for assistance must be in writing; approval also must be in writing for a cheque to be issued. Members should complete the “Request for Service” form for both pre-authorized and non pre-authorized requests. From time to time, the Board of Directors may set limits on individual allocations that may be authorized by committees of the Board.
All Client Service claims must be made within six months of receiving the service.
CLIENT SERVICES WILL COVER:
(Please read preamble and policy to ensure you qualify)
- TV while member is in hospital. This service is available to members with bleeding disorders and carriers.
- Parking tickets for members and family (not friends) while member is an outpatient or in hospital (one vehicle per day to current daily maximum); visits by the member for acute bleeds or clinics would be totally covered. Tickets are held by and distributed by nurse coordinators. Members may remit receipts for hospital parking, within six months of date on receipt, for parking lots that do not take the tickets.
- Expenses for supplies over and above those supplied by Home Care to be considered by the Committee on an individual basis.
- Nutrient supplements (with care team’s recommendation).
- Orthopaedic splints and boots (must be officially prescribed by physiotherapists)
- Protective helmets (with care team’s recommendation)
- Expenses associated with travel for out-of-town medical care for members living 100 km or more from Winnipeg;
- Accommodation when attending Clinic – up to a maximum of $55 per night, for pre-approved accommodation for medical stays – rural members living 100 km from Winnipeg only. Accommodations can be arranged at Lennox Bell or Ronald McDonald House for a maximum of five days or members can choose to stay at a hotel of their choice.
- Psychological services – paid only upon pre-authorization through the counselor and to a registered person – P.A.M. or M.A.R.S.W. Only the standard fee will be paid to a maximum total of $400 and there must be an evaluation by the therapist and the member after six months; treatment granted must be at least 50% hemophilia related. All other possible sources of funding and services should be explored first, including social work services at Health Sciences Centre. An appeal may be made to Client Services for more counseling under certain circumstances.
- Transportation: taxi to/from hospital when there is a disabling situation, maximum of five round trips per month; members are required to call the Chapter office to arrange all taxi service from Monday to Friday. In case of emergencies, after office hours and weekends/holidays members can call directly for service and remit a receipt to the Chapter for reimbursement. Members using the service outside these guidelines risk having their privileges revoked for six months; all other possible sources of funding and transport should be explored first (e.g., social services, public transportation)
- Basic model Medic Alert bracelets or necklaces (limit of one every two years) and the first year enrollment fee; if the bracelet/necklace is lost or broken within the stated period, the Chapter will cover half the replacement cost only. Medic Alert applications can be sent directly from the Chapter or members can remit a receipt for reimbursement.
- When available, the cost of semi-private or private hospital room upon physician’s recommendation and when not covered by a private health plan for members with HIV and HICV only.
- Pagers – up to $100 per year to assist with the cost of carrying a pager (complete details available from the office)
- Product delivery by courier, from Canadian Blood Services, is available only when it is impossible for a member to pick it up themselves.
- Sports Bursary program: this program provides financial encouragement for families to explore appropriate sport activities for children with moderate and severe bleeding disorders. Interested participants must be 17 years of age and under. Families are required to fill out the Sports Bursary application form that must be approved by the Care Team children’s Physiotherapist. Eligible members may apply for 2 bursaries per year, at a maximum of $100 for each bursary. Forms are available from the Care Team, the Chapter Office and on the Chapter web site.
CLIENT SERVICES PARTIALLY COVERS:
(Please read preamble and policy to ensure you qualify)
- Complimentary therapy such as massage or wellness therapy when related to the bleeding disorder – $300.00 per six months, per person; member may re-apply for coverage dependent on written notice from the therapist and patient.
- High top runners or ankle supported shoes – $60/pair (maximum two pairs per year for those 17 and under); and $60/pair (maximum one time a year for those over 18); pre-authorized by care team member strictly required
- Ambulance service – one ambulance per year up to 50% of the cost (maximum of $350) if no other source of funding available
CLIENT SERVICES WILL NOT COVER:
- Educational expenses/re-training expenses
- Routine living or medical expenses, equally incurred by those with or without a bleeding disorder,e.g., dental claims
- Commercial health spa memberships
- Reserves the right to disqualify any request for service which has not been formally pre-authorized
- Winter boots and work-related footwear
ALL ABOVE SERVICES ARE SUBJECT TO AVAILABILITY OF MONETARY RESOURCES.
REQUEST FOR SERVICE
Client Services Request for Reimbursement Form