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Acknowledgment of Disclosures and Authorization
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid. We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour. APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
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V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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Mom had a knee replacement and reconsideration appeal (2nd appeal) was denied. It took 8 days to review and they said she is liable for payment for the 8 days she has been in rehab during review process. She has Medicare and Anthem PPO insurance.
Why do you feel Mom needs more PT? If she went beyond the first 20days that Medicare pays, then yes she owes the 50% that Medicare does not pay. Her suppliment may pay for the balance or partial but with Moms supplement she paid $150 a day 6 yrs ago.
If Mom has reached a plateau or not progressing, Medicare would have her discharged. Why do u feel she needs more time? Knee replacements usually heal fast and people are on their feet soon after. People I know who have gotten PT its usually after they return home after the surgery and they go to a Therapy clinic.
I've had three inpatient rehabs in the last two years. I had no trouble with Medicare approving. All three went over the 20 days that Medicare paid in full. I have BC/BS sor supplement and they paid everything else. I've not had Medicare refuse to pay for anything.
Last year, she fell and broke her right leg which resulted in three surgeries, last one due to an infection. She also needs the right knee replaced but the surgeon did not feel comfortable doing it due to the extent of her injury. He only agreed to do the left knee. So she is working with two bad knees, one is healing and the other needs a replacement ( bone to bone, very painful to walk and her right leg is "windswept" ). Recovery took her longer because of this. She is being discharged now, but they said she would be liable for payment from 1/9-1/18 because the second appeal was denied.
The SNF/Rehab that my father stayed at made false statements about his progress to have him discharged after he made an appeal to stay. Right now he’s on the hook for a little over $1k for 72hrs that went past day 21 at the facility… Oh, but I documented everything. I’m just beginning the process of having his insurance company review what the SNF/Rehab was up to during his stay. Generally, Medicare follows their rules & makes decisions accordingly. However, the upper management at these SNFs will lie, cheat & steal with giant smile. What I’ve observed has truly changed my view of all nursing facilities. If the neglect & apathy don’t get you, the fraud & deception sure will.
I believe it depends on the information provided by your mom's rehab. If they are encouraging her discharge, then, in my opinion, it's probably not feasible to have Medicare approve the appeal. That was the case in my father's situation when he was in rehab. I tried everything for both appeals to get approved - got doctor recommendations for my father and I was very extensive on providing very elaborate feedback for consideration - and both times were denied.
In researching this, I learned that it's a very small percentage of appeals that are actually approved - unfortunately. I hope you receive a positive outcome for your mom's recovery ~
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
If Mom has reached a plateau or not progressing, Medicare would have her discharged. Why do u feel she needs more time? Knee replacements usually heal fast and people are on their feet soon after. People I know who have gotten PT its usually after they return home after the surgery and they go to a Therapy clinic.
Oh, but I documented everything. I’m just beginning the process of having his insurance company review what the SNF/Rehab was up to during his stay.
Generally, Medicare follows their rules & makes decisions accordingly. However, the upper management at these SNFs will lie, cheat & steal with giant smile. What I’ve observed has truly changed my view of all nursing facilities. If the neglect & apathy don’t get you, the fraud & deception sure will.
In researching this, I learned that it's a very small percentage of appeals that are actually approved - unfortunately. I hope you receive a positive outcome for your mom's recovery ~