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And of course there is always the appeal process if for some reason Medicare is not willing to work with your mom until she's placed.
At the rehab my mom is at now, the nurses, aides, therapists, all wonderful both in their professions and in terms of say a bedside manner for lack of a better term
But this SW has been asleep at the job . I finally called my moms Medicare Advantage provider to initiate an appeal which they did. The SW thinks I a meddling and I wanted to (didnt) tell her I would not be meddling if she was doing her job
The SW said yes, but private pay which could be hundreds per night which is not good . This rehab and the AL, indeed the social worker from rehab and the director at AL are close, about a mile apart, and a pipeline of people going back and forth all the time, I assumed the AL Director (who also oversees admissions for the IL my mom has been) were on the same page
I am wondering if I can call her medicare advantage partner to appeal .
That did happen five years ago when my mom was in rehab and we asked for another day do to logistical reasons. The social worker worked with insurance to make that happen .
This SW doesnt seem to try, though maybe thats her job
Call the Medicare advantage plan immediately and find out how much they have paid out already to the rehab.
In all likelihood the rehab is pulling the popular little trick that care facilities like to do when a resident is going to be discharged.
They will bill the full amount and Medicare pays it. Then they collect it in cash from the resident. After the check clears, they evaluate the person and happily discharge them into rehab.
So you tell the social worker who's going back and forth and spinning everything to keep your mother from getting evaluated and discharged, that the rehab isn't getting a cent in cash until the nurse has evaluated your mom and you've checked with Medicare to see how much they've paid.
Trust me, they will get that evaluation done. Don't pay them anything in cash until you've spoken with Medicare and found out how much they've shelled out because they may be owed nothing in cash.
Also, its not 21 days its 20. 21 starts the 50% Medicare pays.
Yes, call her insurance. I have done it and they took care of my problem. They pay the bill. They have the ability to penalize the Rehab. Rehabs contract with these insurances. I too agree that there are good ( have only dealt with a few) and bad ( deal with a lot more than good) Social Workers.