Being stationed at Children's Hospital allows Gwendolyn Madaris to quickly assist  patients with Medicaid problems

Eligibility technician Gwendolyn Madaris sits in a tiny workspace in the middle of Cincinnati Children’s Hospital Medical Center, but she makes a big difference for patients with Medicaid issues. 

“I enjoy it,” Madaris said. “You do not have the hustle and bustle of being at the county. It’s just me.” 

Since last summer, Madaris has determined medical coverage for children and, occasionally, pregnant women. She handles Hamilton County cases, although she gets inquiries from people who live in other states and countries. 

“I answer an abundance of questions from people from all over the hospital,” said Madaris, the only Hamilton Department of Job and Family Services worker at the facility, other than child protection staff. “They know I’m here. I get calls from clinics and social workers who want to get the kids on medical coverage.” 

Madaris’ office is located in an area of cubicle walls constructed in a lobby up a flight of stars from the hospital’s main entrance. The office is situated around the corner from the hospital pharmacy. 

“When they go to the pharmacist and they can’t find or do not have coverage, they come up here,” Madaris said. 

Madaris started working at Children’s Hospital in July 2008. She had been located at the agency’s 237 William H. Taft offices. 

“I happened to be here at a health fair, and they were saying they were going to get a county worker,” Madaris said. “I had no idea it would be me.” 

Madaris e-mails staff downtown to research cases. Sometimes she learns that consumers are entitled to coverage; sometimes, not. At times, consumers aren’t getting coverage due to their neglect at filling out paperwork and bringing in documents. Occasionally, a caseworker may have improperly processed a case.  

Regardless, she helps iron out the situation.  

“I check to see if they are active in CRIS-E (computer system),” she said. “If not, I help them do an application. If they are and there is a situation, I e-mail the worker and supervisor to see if I can assist or explain to the consumers what is happening. They may have gotten a letter that they didn’t understand because it wasn’t in layman’s terms.” 

Recently, for example, she found out that a parent had let a child’s coverage expire by not reapplying after six months, as was required. 

Cases can get very confusing, with families losing private coverage due to job loss, receiving Medicaid, then getting a job and returning to private coverage.  

“I let people vent,” Madaris said. “Then we’re down to brass tacks.” 

Parents can be very emotional. The stress from dealing with their child’s illness as well as confusion of medical coverage compounds the problem.

“Some come in crying,” she said. “They need somebody to talk to, a shoulder to cry on.” 

Or a hug, such as the one she gave to a grandmother whose daughter had endured a miscarriage.  

Madaris, the single mother of three adult children, understands how the parents feel. She often took her daughter, now 38, to the Shriners Hospital in Lexington, Ky., for treatment of a serious childhood condition. A newspaper clipping from 2001 about how her daughter overcame the illness and graduated with a biology degree from the University of Cincinnati hangs in her cubicle. 

“I saw kids with disabilities a lot, so it doesn’t shock or disturb me here,” Madaris said. “My passion is helping. I enjoy it. There are a lot of very nice people here.” 

Mindy McDulin, manger of Financial Counseling and Customer Service at Children’s Hospital, appreciates the arrangement. 

“We’re extremely lucky to have Gwen,” McDullin said. “We’re able to utilize her as a resource to answer patients’ questions. We can actually come right over and ask Gwen a question, instead of making a phone call, leaving a voice mail, and waiting for someone to get back to us. Having her on-site is a huge plus.” 

Besides answering questions, Madaris often can expedite cases. She can help parents avoid a trip to the agency’s busy downtown offices. 

“She’s got 30 years of knowledge,” McDullin said. “And we know if she doesn’t know the answer, she knows who to contact. It’s been nothing but positive having her here.” 

Elaine White, Madaris’ supervisor, added: “Gwen manages hundreds of inquiries/contacts monthly. She is compassionate and recognizes the importance of medical coverage. She goes over and beyond to resolve Medicaid issues.”