A couple of things changed this evening. After 5 p.m. a Blue Cross insurance representative, who claimed to have tried reaching Mother before, called to say that it was likely that if Mom went to Health Southeast her insurance would NOT cover it, for a complicated set of reasons including that Mom got a single knee replacement instead of a double knee replacement and that Mom is still just barely walking to use the commode next to her bed and so might not be ready for 3 hours of therapy a day. Some of Mom's friends had highly recommended Health Southeast as a rehab place that among other things was more intensive and more comprehensive, but Mom also realizes that they had slightly different injuries/needs than her. Mom had dropped by Health Southeast to check out the temperature last week.
Obviously, in hindsight, we should have checked more with Blue Cross before making these plans and tellling friends and church that's where she is going. A problem is that it's the weekend, most of the regular staff isn't here, we can't easily talk with Dr. Fahey, and we can't even call Blue Cross back until Monday AND Mom is slated to go to Health Southeast Monday. I can't tell whether Health Southeast really specializes in "more serious" issues (like brain injuries) and Mom really isn't strong enough to take the treatment and so it makes just as much sense for her to go to one of the two other places in town, probably the one down the street affiliated with this hospital, or whether Health Southeast is simply better and more expensive and Blue Cross might not pay just because it's more expensive. The Health Southeast reps that had stopped by each day, in hindsight, did not take the possibility of insurance problems very seriously.
Mom has been telling them that Dr. Fahey recommended Health Southeast, but really he assumed that she would go to the hospital clinic until she pushed for Health Southeast, then he seemed fine with that. Saturday we'll hope to talk with the Saturday day head nurse who we've seen during the week also, whichever of Dr. Fahey's colleagues is covering the weekend, and the "case manager" who may know the most about clinics and the insurance company, since this person helps plan people's discharges from the orthopedic clinic. In the interim, somewhat under the guise of visiting a church friend there, I dropped by the Tallahassee Memorial Hospital clinic this evening (hospital complex pictured above in the background, with my old high school [Leon] pictured in the foreground), got a quick tour, and talked with a staff person there (who made a pitch for it). Maybe I'll also stop by Health Southeast on the way in in the morning.
Another change: they took Mom's nerve block and catheter out this morning, you'll recall. But this evening the head nurse and Mom decided to put it back in so she doesn't have to get up to go to the commode every couple of hours at night. He talked about leaving it in until the weekend physical therapist comes midday tomorrow. I'm not sure the doctor or PT will be happy, but they will all be subsitutes.
If we wait until Monday to do anything - again, contrary to what we had talked about - we'll get a chance to talk with all the usual people again, but we'll see what happens. I don't think it's very likely that Mom will go to Health Southeast Sunday. If she goes anywhere Sunday, it'll probably be to the hospital's rehab clinic, if they have room available.
I also got out to shop for birthday presents for Mom (her birthday is Monday).
Obviously, in hindsight, we should have checked more with Blue Cross before making these plans and tellling friends and church that's where she is going. A problem is that it's the weekend, most of the regular staff isn't here, we can't easily talk with Dr. Fahey, and we can't even call Blue Cross back until Monday AND Mom is slated to go to Health Southeast Monday. I can't tell whether Health Southeast really specializes in "more serious" issues (like brain injuries) and Mom really isn't strong enough to take the treatment and so it makes just as much sense for her to go to one of the two other places in town, probably the one down the street affiliated with this hospital, or whether Health Southeast is simply better and more expensive and Blue Cross might not pay just because it's more expensive. The Health Southeast reps that had stopped by each day, in hindsight, did not take the possibility of insurance problems very seriously.
Mom has been telling them that Dr. Fahey recommended Health Southeast, but really he assumed that she would go to the hospital clinic until she pushed for Health Southeast, then he seemed fine with that. Saturday we'll hope to talk with the Saturday day head nurse who we've seen during the week also, whichever of Dr. Fahey's colleagues is covering the weekend, and the "case manager" who may know the most about clinics and the insurance company, since this person helps plan people's discharges from the orthopedic clinic. In the interim, somewhat under the guise of visiting a church friend there, I dropped by the Tallahassee Memorial Hospital clinic this evening (hospital complex pictured above in the background, with my old high school [Leon] pictured in the foreground), got a quick tour, and talked with a staff person there (who made a pitch for it). Maybe I'll also stop by Health Southeast on the way in in the morning.
Another change: they took Mom's nerve block and catheter out this morning, you'll recall. But this evening the head nurse and Mom decided to put it back in so she doesn't have to get up to go to the commode every couple of hours at night. He talked about leaving it in until the weekend physical therapist comes midday tomorrow. I'm not sure the doctor or PT will be happy, but they will all be subsitutes.
If we wait until Monday to do anything - again, contrary to what we had talked about - we'll get a chance to talk with all the usual people again, but we'll see what happens. I don't think it's very likely that Mom will go to Health Southeast Sunday. If she goes anywhere Sunday, it'll probably be to the hospital's rehab clinic, if they have room available.
I also got out to shop for birthday presents for Mom (her birthday is Monday).
2 comments:
Hi Perry,
I just left you a message on your cell phone. Hope your mom is doing well!
Perry, be sure to tell Martha that Bob and I wish her a very happy birthday. I know all about not being able to use the bed pan and thank God for the porta-potty.It seemed like forever before I could walk after my various foot surgeries. I was very happy to get rid of the walker and only use my cane.
Nancy
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