I was given an ABN paper to read, check a box, sign and return it. I discussed it with my sibling and we agreed a certian way. Today I get an email response saying that if I don't resubmit it, with a different and specific box checked, then my mom can't stay there. Is that legal for them to do that?
Like you I was flabbergasted to suddenly receive this notice that she would be discharged in 2 days and that they wouldn’t help me appeal. It was an eye opener for me. I had 48 hours to do it so I appealed, and was denied. And then I pulled her out on the last day while they said they wouldn’t allow it or something, and demanded that I sign some type of unsafe discharge paperwork. I was absolutely furious. She went home with me, and in two days she was back in the hospital. Funny thing, the night before she went to the hospital I got a call from Medicare saying mea culpa (or rather they blamed the facility) and Medicare said that, in retrospect, they now have approved my appeal for 12? or 20? more days. And I said “too late she’s out”. It felt like Medicare doing CYA anyway. The next morning she’s back in hospital, having taken another big fall with so many drugs in her.
Sorry for my rambling. I apologize to some of the posters here who are medical professionals and therapists etc. You understand the system much better but those of us who are “customers” can sometimes feel like we have been sucked into a meat grinder!
My heart goes out to people that don’t understand the system, it’s hard enough when you do. That’s why I try to answer questions here when I think I know something, always to be taken with a grain of salt lol.
The ABN can’t be given right away because no one knows how a patient is going to progress with therapy or how long nursing needs will continue if that’s the qualifying factor. Sometimes a patient will do much better than expected and continue to make progress for weeks. Other times, they may plateau for a variety of reasons, such as medical conditions, willingness to participate, etc. I would often write “maximum benefit achieved from therapy” on the ABN if goals were not met and it was clear they were not going to be. In my experience, therapists tried to give patients every chance to improve.
I cringe when I hear that people are expecting the full hundred days of skilled inpatient services. You have a better chance of receiving those with traditional Medicare but even then, there has to be a skilled need with progress made. Apologies if I’ve misinterpreted your situation and I’m sorry you’re having to deal with this.
I'm hoping I'm making sense, as all my life nearly everybody doesn't understand how I explain stuff.
There is only quarterly meetings I believe my sister informed of a couple nights ago. But it seems like for some things that isn't enough.
I am currently talking about info from https://www.medicareinteractive.org/get-answers/medicare-denials-and-appeals/original-medicare-appeals/advance-beneficiary-notice-abn
I understand what this means but don't remember signing anything for Mom like this. I guess they can ask you to check the box or she can't stay? We need to know what box you did not check.
This sounds like its to protect Mom and them to. I have seen alot a Medicare statements where Medicare is billed and they don't except the charge. It ends up just being a matter of the facility to recode to get paid. Also, Medicare only pays 80%. Mom will owe the 20%. So if asking if Mom (or POA) that she understands she is responsible for any balances left after Medicare pays what they deem as reasonable, the answer is yes. She either has a suppliment that pays the 20% or she pays the balance.
The question is more about they have stated, if I don't check the box making mom 100% liable, she can't stay there. As stated elsewhere, the form also states they can't choose for me/her.
Yes, it is legal for them to reject your Mom as a resident based on ability to pay.
But, more clarifying info from you would be helpful. Need to know what is the agreement connected to that specific box.
Also, in your response to AlvaDeer, do you mean Medicaid, not Medicare?
The form says they can't choose for me, but yet they've stated that if I don't choose box 2(putting mom fully responsible and Medicare not being billed), then she can't stay there.
That to me is against what the form says they can legally do.
Nope, Medicare is accurate as she's currently only on Medicare. Medicaid has been applied for, and being processed.
Thanks
It's about a possibility of no coverage from Medicare for services rendered to someone that you are a POA for.
Just thought I might find someone who's experienced recieving one and having to sign it.