Case manager: "Medicare is saying it will only pay for rehab or the life vest. It won't pay for both."
Me: "But without that life vest he stands a pretty good chance of dying. Why can't they just do the surgery to put his internal defibrillator in now?"
Case manager: "Medicare rules state that he has wear the life vest for 60-90 days before they put the defibrillator in."
Me: "Why? That's stupid."
Case manager: "The Medicare person I talked to said they have to give the problem a chance to fix itself."
Me: "And by 'fix itself' they mean 'we hope the patient dies before we have to put this $20,000 piece of hardware inside him,' right?"
Case manager: "That's how I understood it, too."
#logical
1 comment:
In cases where I have seen this before the case manager always tells us its make sure the patient will make the appropriate "lifestyle changes" first. These have all been realitively young people and a few were drug users.
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