My mother-in-law entered a rehab center after breaking her hip. After two months, the original rehab told us that medicare would no longer pay and, since she was not able to live alone yet, they transferrred her to a nursing home. My mother-in-law contacted her medicare replacement plan and was told that she still qualified for more days. She asked the nursing home to contact insurance plan. They told us that she did not qualify and started the process of applying for medicaide. Because they admitted her as a medicaide patient, they did not give her therapy while she was there. Two weeks later, I moved her to a new rehab center in my town. The new rehab center discovered that she had medicare days left and gave her much needed therapy that allowed her to walk out of there with only a cane when her medicare days were finished. Her medicaide application for the nursing home was denied and now they want her to private pay for her two weeks.
When she entered the second rehab center, we asked if the nursing home could bill her medicare replacement plan. We were told that it wasn't an option because they had not provided her therapy when she was there. Her medicare plan shows that the nursing home did not submit any bills to them whatsoever. She received one bill nine months ago from the nursing home asking for the private pay fees. Now she has been contacted by an attorney to collect on her bill.
She feels that she should not be responsible for paying the bill because it was their mistake. If the nursing home had simply contacted her medicare replacement plan themselves, instead of taking the word of the first rehab center, then my mother-in-law would have gotten therapy at the nursing home and medicare would have paid her bill in full.
The nursing home is now claiming that she never provided her with her medicare card so they were unable to bill the plan and actually scolded her on the phone today. I watched them photocopy it on the day she was admitted and heard her ask them to check on it for her, but I'm afraid it is just my word against theirs.
What are the legalities involved in a nursing home that fails to bill medicare even when you ask them to do so?
I assume she had to sign something regarding payments when she was admitted, does that mean she will be stuck paying or having a lein against her house because they failed to check with her medicare plan for themselves?
This is one of the reasons why we have to consider long term care insurance because we get measly medical assistance from the government and the costs of care are increasing as we age.