Medicare Managed Care Chronicles: After all, she’s 91… … (Part 2)
We waited all weekend for a response. Did we need to move
her or not? It was a time of uncertainty, which caused her blood pressure to
rise and her progress to regress a bit. The rehab facility staff said the delay
was unusual. Responses to appeals were usually received quickly, usually within
the hour. We were at a loss to know what to do. It was a holiday weekend. No
one could answer any questions. Her discharge date was scheduled for Memorial
Day. We had made arrangements with Assisted Living, but they could not receive
her on the holiday.
We didn’t receive any response until two days after Memorial Day, on May 30 at 4:00 pm
when staff informed me that they had received a verbal denial. I called HSAG again.
The rep said that the earlier denial would stand. The last covered day would be
May 30 (today). I asked her the reason for the denial. She said that the
patient was medically stable and ambulating independently for 200 feet. This
was not true and not what the record said. The rep said that they had determined
that she had hit her plateau. “After all,
she is 91.”
Photo Credit iStockphoto
Labels: elderly parents, HMO, Medicare, rehab, United Health
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