K
kbrisse
Guest
What is the name of your state? NJ
My mom is 69 however has insuracne thru employer. She has metastatic breast cancer resulted in bowel perforation and surgery on 9/24. Insurance wanted her discharged from hospital after 2 week stay so she then went to subacute rehab center. Insurance now wants her discharged home however she is not ready to go home as she still needs rehab (both PT and OT)..even the homecare agency doesn't feel she is ready to go home yet. They will only cover her stay from 10/9 to 10/30. Her rehab was delayed because her surgical sutures were not removed until 11/4.......poor coordination of care with new doctor overseeing her at the rehab center (also have a complaint about him). She now has cancer in her eyes and is on radiation which is delaying her rehab even more (She's exhausted). We've appealed twice thru the insurance company and they have upheld their decision. I would like to now appeal thru the state. I'm not familiar with NJ (I live n Mass)....what to do ?? This, to me, is a blatant inappropriate decision by their medical management team. They are forcing her into an unsafe situation at home. They are denying my mother medically neccassary rehab services. I would also like to seek legal counsel but cannot find a lawyer in NJ that handles health insurance. Can you advise, please!!
My mom is 69 however has insuracne thru employer. She has metastatic breast cancer resulted in bowel perforation and surgery on 9/24. Insurance wanted her discharged from hospital after 2 week stay so she then went to subacute rehab center. Insurance now wants her discharged home however she is not ready to go home as she still needs rehab (both PT and OT)..even the homecare agency doesn't feel she is ready to go home yet. They will only cover her stay from 10/9 to 10/30. Her rehab was delayed because her surgical sutures were not removed until 11/4.......poor coordination of care with new doctor overseeing her at the rehab center (also have a complaint about him). She now has cancer in her eyes and is on radiation which is delaying her rehab even more (She's exhausted). We've appealed twice thru the insurance company and they have upheld their decision. I would like to now appeal thru the state. I'm not familiar with NJ (I live n Mass)....what to do ?? This, to me, is a blatant inappropriate decision by their medical management team. They are forcing her into an unsafe situation at home. They are denying my mother medically neccassary rehab services. I would also like to seek legal counsel but cannot find a lawyer in NJ that handles health insurance. Can you advise, please!!