Seriously, that was my first thought. And, if you haven’t been shopping for a long term care (LTC) or skilled nursing facility (SHF) lately you may not have a deep understanding of the process that led to this unkind thought.
You see, I already knew the medical conglomerates have a major issue with padded and fraudulent bills, erroneous or absent billing procedures & a sad track record of seeking and obtaining prior authorizations for expensive procedures. Those I can resolve.
So why was I surprised to find the greed & unfortunate miasma has spread to SNF’s? Finding one that doesn’t “pre-cost” a stay and use a carefully crafted script to explain they’ll be over-charging the patient’s family – well above and beyond what the insurance contract pays – is like looking for the real in today’s world of artificial.
And it truly is senseless. Each one we visited is under-staffed, underwhelming, filthy, and ugly with a syrupy admissions rep blathering on about invisible skilled on-site practitioners and non-existent (based on visual evidence) commitments to service standards they can barely pronounce.
Make no mistake, I know what medicare and medicare advantage plans pay for SNF rehab. I know how long a stay is allowed. I know the extension of that stay has to be pre-authorized and carries a daily co-pay.
However, I, unlike these facilities, also know that balance billing (or charging the patient more than the contracted amount of the MA plan), is outright ILLEGAL. And now that I see they are pre-planning their excess collection of funds from the stressed-out, ill-prepared, and mis-guided family of the patient – I’ll call it what it is. Fraud.
I made this journey in the last two weeks with a friend and client. Why? Because every day they’re bombarded by people in the medical industry and industry-owned social workers telling them that which isn’t true and right. Then, they tell the in-laws and extended family the spouse isn’t cooperating or doing what is best for the afflicted spouse. Spin up a little drama much?
Can you feel her stress, frustration, and hurt from here? It’s palpable.
Luckily, I have been able to assist and hope for the best available outcome. It’s sad to note that Medical Debt Reduction is going to be a necessary business offering for the remainder of my career.
If you’re in over your head with medical debt, I invite you to schedule a complimentary chat with me.
If you had a feeling the medical facility has maneuvered you into a corner where only copious amounts of $$$ will release you, no – you are NOT out of your mind. They are.
So, which is better for you? Pay more than you owe or only pay that which you owe?
©2023 Ronda Cobb, the Money Coach™
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