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Post by Frostym on Apr 16, 2014 16:06:45 GMT -5
Marci-That's what am really afraid of- that they will wear out beyond surgery. But I think I'm good for the op. I'm so sorry about your mom. I know you still miss her.
DB- I've lost nine pounds since I got serious about this surgery. Whenever I get hungry I eat half a grapefruit. There's an enzyme in grapefruit that keeps you from being hungry. Today I've had half a cup of oatmeal and a handful of pecans and dates. Tuna for dinner. I feel much better with those pounds gone.
Ride4Fun- That's a great idea about hiring somebody from the church. But, maybe I should ask first if any of the youth group would like to volunteer. They're great about showing up and doing whatever.
snelson, I love hearing about your aunt. Any encouragement is great. Thanks. Please keep these ideas coming.
Great ideas, everybody. Keep them coming.
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Post by Idaho Linda on Apr 17, 2014 14:22:40 GMT -5
Remember, we are trying to make sure you qualify for skilled nursing. Not having anyone at home to help would be one more reason why you should be admitted there. Make sure your surgeon knows you don't have anyone at home to help you.
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Post by Frostym on Apr 17, 2014 17:01:04 GMT -5
Idaho Linda, thanks so much for your advice. Doc and I are having a meeting two weeks before the op. He told me to bring all my questions then. This will be number one on my list. When we talked at our first meeting, he knew that the three midnight rule applied to skilled nursing but didn't think I would need more than the rehab. I worry about catching an infection in the hospital for which I would need skilled nursing. How do you think I should phrase the question?
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Post by Idaho Linda on Apr 17, 2014 18:49:10 GMT -5
Rehab can take place in skilled nursing. What I don't know--and you need to find out--is who is going to pay the rehab. I am not sure how it is billed under Medicare.
Talk to the billing people. And, something else you can do is go to Medicare.gov and put that in the box that says, "Is my test or procedure covered?"
You want to be covered for skilled nursing, just in case. It is just a back-up plan in case something unforeseen goes wrong. I think you see it that same way--especially since you don't have anyone at home to help. You aren't looking for a free ride, you are just trying to cover your bases just in case. You need to communicate that---it is just-in-case. You aren't planning on going to skilled nursing, you have things to do at home. But, if necessary, then you know it is a covered expense.
I do not understand what he plans to do with you for that "discharge into rehabilitation." That is where you need to talk to the billing folks at the facility and figure out who pays what. That may be into a "swing bed" for Medicare billing. If it is (the hospital's equivalent of skilled nursing), then I don't know for sure what the billing implications are. My friend at the local hospital is off all this week or I would ask her.
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Post by Frostym on Apr 17, 2014 20:08:24 GMT -5
Thanks for reminding me about going to the hospital billing and asking these questions. I need to update my to do list. I also need to call the rehab and the hospital to make sure I can get no sugar, no gluten diet. My cholesterol has dropped 30 points since I started this. Over decades nothing has helped like this.
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Post by Vicki on Apr 18, 2014 13:20:35 GMT -5
My Dad stayed in a rehab facility after his hip replacement in November. In order to qualify for Medicare to fully pay for the first 20 days of rehab, he had to stay in the hospital for 3 nights post surgery. We just made sure the doctor knew he lived by himself and would have no one nearby to help him I.e getting to the bathroom, if he fell, prepping meals, making sure the incision did not get infected. He stayed in rehab for 30 days. Medicare paid 100% for the first 20 days. After that Medicare paid for 80% and Blue Cross picked up most of the other 20%. For 30 days of rehab, PT once a day, OT once a day, 3 meals/ days, and a full nursing staff, he paid less than $100 from his own pocket. The rehab facility should have a social worker that knows the insurance rules. The surgeon should also know how to ensure you qualify as well.
The rehab facility was very, very nice too. He had his own room, tv, bathroom and the nurses were constantly checking on him.
It was such a great peace of mind for me not having to worry about taking care of him and transporting him to therapy.
Also if you do not go this route, how would you get to physical therapy with your son taking care of the new baby?
My aunt did the same thing after having a knee replacement. She loved it too as she did not have to put that extra stress on her family.
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Post by Vicki on Apr 18, 2014 13:23:53 GMT -5
Oh, while in the hospital after surgery. You need to double and triple check that the nurses on your wing know you want to go to a rehab facility. The nurses almost discharged my Dad early as they did not realize his wishes. As far as I know the 3 nights at the hospital is essential inorder for Medicare to pick up the tab.
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Post by Idaho Linda on Apr 18, 2014 14:13:29 GMT -5
Vicki, that is absolutely correct. Three MIDNIGHTS (that is the time cut-off.) The rehab facility has to bill as "Skilled Nursing" in order to meet Medicare's requirements.
Your family did a great job of making sure everyone understood your dad's needs and wishes.
3 midnights, then admitted to skilled nursing for the same condition as the patient was in the hospital for. Everyone needs to memorize that part of the Medicare manual that is mailed to them.
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Post by Frostym on Apr 18, 2014 15:47:45 GMT -5
Vicki, thanks so much for the info about your dad. That is great to know. I'm hoping the doc will let me stay in the rehab place at least until I can drive. Then I can take care of myself.
Idaho Linda, I'm so frustrated. I woke up loaded for bear and called the hospital. Offices closed for Good Friday. Oh well, I can ask on Monday. The rehab center is part of the hospital so I don't believe I'd have to be readmitted or have a different billing code but that's important and I'll surely ask.
We're having nice warm weather here so my knee is feeling much better. Now I'm wondering if I can put the surgery off, but my DIL is having a fit because at no time in the foreseeable future will my sons be around to take care of me. Basically, I don't wanna- I want to stick around and be there when my new granddaughter is born. Waaaaahhh. Poor me with my first world problems.
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Post by Idaho Linda on Apr 18, 2014 16:13:53 GMT -5
Frosty, that IS a different billing code. You can get a different billing code and still stay in the same bed. Hospitals are in this business to make money. Don't forget that. How are they coding the "rehab center"? That is the issue. As long as they leave you admitted as an inpatient for the three midnights, it doesn't matter if they have some other way of making money off a Medicare code. You still would have met the requirements for Skilled Nursing.
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Post by Marci on Apr 19, 2014 22:24:39 GMT -5
Will she be giving birth at the same hospital? That way you could be there already. I would have it done while the weathers good. Not too hot or too cold.
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Post by Trailpal on Apr 20, 2014 0:36:02 GMT -5
I hate to mention it, but if they are closed for Good Friday, they may also be closed for Easter Monday. Just be prepared
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Post by Frostym on Apr 20, 2014 20:04:12 GMT -5
Marci, No I wish. The hospitals are on the same street about ten miles of city driving apart.
Trailpal, I hope not still closed but if so, no biggie. It's still a while until my op.
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Post by Marci on Apr 20, 2014 22:14:43 GMT -5
Bummer.
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