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Tajann Asked December 2021

Why would insurance deny an inpatient rehab stay after surgery?

My mom has been in the hospital for several weeks. During her stay, she developed a blood clot and infection (post surgical from October) that required another surgery during this admission. She is unable to ambulate without assistance and today I was informed by the social worker that her insurance didn't approve her stay to an inpatient rehab. Now they are going to submit a peer to peer but what happens if that doesn't get approved? What are her options? She is non weight bearing on the surgical leg. And to top it off, she developed a fever today. I'm concerned as she has been hospitalized since Thanksgiving and with COVID numbers rising, that is the last thing she needs.

BarbBrooklyn Jan 2022
I believe this issue is moot.

The OP's mom went to rehab and was then taken home by one of her grandchildren.

LifewithDignity Jan 2022
She may not be appropriate for the hospital inpatient rehabilitation unit, but she could go to a skilled nursing facility for rehabilitation. Ask them about inpatient stays at a skilled or subacute rehab center.

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MJ1929 Dec 2021
I'd say that someone didn't do the proper paperwork or use the correct coding to refer her to a rehab place. I'll bet she'll be OKd the second time around. The fever will keep her in the hospital for the time being.

Don't get too excited about a rehab hospital, though. My mother was in the hospital for 10 days last December, and it was run tight as a ship as far as keeping things clean and safe. She went to a rehab place for an additional five days, and that's where she caught Covid. She was almost completely asymptomatic and recovered, but she ended up with some other stuff as a result that was not good.

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