February 28, 2018

Consequences of Being Healthy

Just when you thought it was too good to be true!!!

Lyn, my dear friend, just had a total knee reconstruction. She prepared herself for surgery by walking, exercising, strengthening herself for post-op recovery. She did all of this in extreme pain, she was supposed to have surgery last May but ended up putting it off (partly to build herself up).

She has state-of-the-art surgical procedures and surgeon. Typically a Total-knee takes a minimum 3 day hospitalization. Lyn went in with the mindset that she was going to do it in two days!  Huge winter storm threatening the west coast, prediction of 4 to 6 feet of snow east and west of us was a bit of a factor.

This morning, her doctor is totally blown away by her progress. First night after surgery she walked 70'! Yesterday she was making loops around the nursing station. He gives her the go ahead and signs the discharge papers.

Twenty minutes later, just before we walked in to bust her out, she gets a visit from the finance department. Medicare is denying a huge portion of her costs!

Why, you might ask!

Medicare informed her that her stay at the hospital is considered "outpatient" care because she didn't spend three nights in the hospital. Because it is an outpatient procedure, they are only going to cover a small portion of the costs.

Layman's terms: Because you got better faster it's going to cost you more!

Great method Medicare has adopted to help a person recover from major surgery?

Medicare friends, stay or pay!


10 comments:

  1. Crumbs ... I say - and sorry to read it .. good luck to Lyn ... Hilary

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  2. Well, isn't that just a sonovabitch. Is there an appeal process or can the doctor write a letter on her behalf or something?

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    1. There probably is an appeal process. We'll check it out.

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  3. thats disgusting,, ridiculous and they should be ashamed!!!

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    1. I'm not sure that the Feds know the definition of shame.

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  4. Oh those bast*rds! Any excuse to get out of paying... How disgusting. I hope she finds her own loophole to make this thing go her way!

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    1. She'll definitely challenge it. Born and raised in Queens, she doesn't take anything lying down. She is definitely a "Not fer nuttin'" kind of gal!

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