7/6/24 - Update on My Husband
By LindaOH
@LindaOHio (194292)
United States
July 6, 2024 2:07am CST
Where do I start?
Was unable to visit my husband today because of this darn infection. This is the third go-round with medications. I've been prescribed a sulfa drug this time.
During physical therapy yesterday, my husband was given a call (he doesn't know from where which really worries me) in which they asked him a whole bunch of questions about how he was doing, did he think the PT was helping, etc. I wonder if this could be related to the hearing?
I received the packet of material from the US Department of Health & Human Services today for the hearing/appeal. There are about 10 pages of instructions and another form that I must fill out and return within 5 days (don't know where it's supposed to be sent). The offices must have been closed for the holiday because I got an answering machine. Have no idea if I called the right number as several were listed.
Hubby will receive physical therapy on Sunday (tomorrow) for some reason.
I received a rundown from our insurance company of charges from March 17 through May 11 (the day we went on self-pay). It was for over $45,000.00. When we went on self-pay I spoke with the woman in the Business Office. I asked her if we would be receiving any other bills other than the $300 per day for a semi-private room. After asking her THREE TIMES, she said there could be charges for physical therapy. If we get a bill for May 11 through when my husband comes home; and it's for $45,000-$50,000, I am going to have a baby; and then I will wreak havoc on the Business Office. We HAVE to win the appeal.
Would appreciate any prayers, support and thoughts you can spare!
Photo Credit: Pixabay
21 people like this
20 responses
@NJChicaa (123581)
• United States
6 Jul 24
It isn't my business but what the hell insurance do you guys have? Just Medicare or something more? Regardless I don't understand how they could have wanted to kick him out a month or more ago when he still can't get out of bed or walk much on his own. That isn't even humane and shouldn't be legal. Having to pay $50,000 out of pocket for him to pretty much be treading water and barely making progress should be illegal.
7 people like this
@LindaOHio (194292)
• United States
6 Jul 24
We have a Medicare Advantage plan. Any insurance company wants to cut you off after a certain amount of time. My husband has been gone since February 1 and the insurance company has paid out close to a half million dollars. They get reports from the physical therapy staff; and that's when we got cut off. That's why I appealed and have the hearing on the 17th. I doubt we'll win; but I had to try.
1 person likes this
@NJChicaa (123581)
• United States
6 Jul 24
@LindaOHio it is insane. He obviously isn’t fit to be discharged yet.
4 people like this
@Juliaacv (54152)
• Canada
6 Jul 24
@LindaOHio If you are expected to pay in advance, what is the turn around time for a reimbursement should that need arise?
2 people like this
@LindaOHio (194292)
• United States
6 Jul 24
I haven't received an invoice for July yet. They want 30 days in advance @ $300 per day.
2 people like this
@LadyDuck (478768)
• Italy
6 Jul 24
Oh my goodness, there is something so wrong here, they are asking you too much money.
Surely they called your husband to check if it reasonable to continue to pay or if he is not progressing enough despite the PT and they are no more going to pay.
2 people like this
@LindaOHio (194292)
• United States
6 Jul 24
They get their reports from the physical therapy department and make their decisions based on those reports.
2 people like this
@LadyDuck (478768)
• Italy
6 Jul 24
@LindaOHio Weird that they called him directly.
3 people like this
@LindaOHio (194292)
• United States
7 Jul 24
@LadyDuck Yes, I wish he would have remembered who the call was from.
1 person likes this
@just4him (318811)
• Green Bay, Wisconsin
6 Jul 24
@LindaOHio No, they don't. But it shouldn't be their choice to decide when enough is enough. They need to consider the health of their client.
1 person likes this
@LindaOHio (194292)
• United States
6 Jul 24
@just4him That's why I filed the appeal.
2 people like this
@LindaOHio (194292)
• United States
6 Jul 24
He's been in rehab over the usual amount of time times ten. Insurance companies don't want to pay for that long.
2 people like this
@lovebuglena (47188)
• Staten Island, New York
6 Jul 24
That’s too much money. Can you refuse to pay that? Or at least settle on a much smaller amount?
2 people like this
@lovebuglena (47188)
• Staten Island, New York
11 Jul 24
@LindaOHio I wonder when he will be ready to finally come home. This has been dragging way too long...
1 person likes this
@LindaOHio (194292)
• United States
12 Jul 24
@lovebuglena I don't know. We keep saying "2 weeks"; but that 2 weeks never comes.
@LindaOHio (194292)
• United States
7 Jul 24
No, we can't refuse to pay because we had the option to take him out and bring him home. (which he wasn't ready for)
1 person likes this
@GardenGerty (164693)
• United States
6 Jul 24
Maybe Sunday PT is to make up for the fourth. Insurance surely is complicated.
2 people like this
@LindaOHio (194292)
• United States
7 Jul 24
Thank you, Amber. It's definitely concerning.
1 person likes this
@kaylachan (78770)
• Daytona Beach, Florida
6 Jul 24
The call your hubby got was part of the process for your appeal to ensure he's safe and getting what's supposed to be offered. I hope you get the rest of this figured out.
2 people like this
@kaylachan (78770)
• Daytona Beach, Florida
7 Jul 24
@LindaOHio The insurance company wants to get out of paying.
1 person likes this
@LindaOHio (194292)
• United States
7 Jul 24
The insurance company wants to win. I wish I could have been privy to that call.
1 person likes this
@LindaOHio (194292)
• United States
7 Jul 24
This was just from the insurance company telling us what the rehab facility billed. We do not have to pay that one. However, we are responsible for May 11 through when my husband comes home. That's very concerning.
@RasmaSandra (86812)
• Daytona Beach, Florida
6 Jul 24
Wishing you both all the best and many blessings, I hope he can finally come home soon, The charges are outrages,
2 people like this
@kobesbuddy (78856)
• East Tawas, Michigan
9 Jul 24
Insurance should be footing these atrocious bills, not the patient's family!
1 person likes this
@kobesbuddy (78856)
• East Tawas, Michigan
10 Jul 24
@LindaOHio With insurance, whatever work is done, our insurance will probably reject it.
1 person likes this
@Beestring (15611)
• Hong Kong
6 Jul 24
Hope your infection goes away soon. Take care.
2 people like this
@celticeagle (176827)
• Boise, Idaho
7 Jul 24
All my thoughts and positive vibes going your way. I wish you could get on Medicaid or some better insurance. That is a hefty bill. Isn't there any disability you could get? Out-of-pocket is going to mean you will be paying for this for ages.
1 person likes this
@celticeagle (176827)
• Boise, Idaho
8 Jul 24
@LindaOHio .......That's great then.
1 person likes this
@LindaOHio (194292)
• United States
7 Jul 24
We both retired on disability. My husband has had almost a half million dollars worth of charges this time around. We are lucky to have the insurance we do have.
1 person likes this
@jobelbojel (36862)
• Philippines
7 Jul 24
I hope you get the correct number and know where to return the signed form. All the best!
1 person likes this
@FourWalls (76588)
• United States
7 Jul 24
It’ll take you five days just to read the instructions! 
1 person likes this
@LindaOHio (194292)
• United States
7 Jul 24
I have a list of questions to ask them on Monday.
1 person likes this
@LindaOHio (194292)
• United States
7 Jul 24
Thank you, Dena. I hope to see him today. 
1 person likes this
@MommyOfEli2013 (85191)
• Rupert, Idaho
6 Jul 24
Wow.... I wish I even knew what to say to all that!
1 person likes this
