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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™