I should further clarify.The notice is given 48 hours prior to therapy ending.That 48
hours gives the patient the right to have the indep group review the claim by the time
the 48 hours is up.That way the manage care company does not have to pay for further
days if the claim is in their favor.As I said no one has yet asked for a review.I am
anxious to see what will happen when it does happen.The group in Mass who do the
reviews have a very good track record.They in years past would send a letter to a
medicaid resident who had been on medicare A recently and ask them if they felt their
rights were denied.Had the facility taken them off med A too soon.Of course the
medicaid program was looking to recoup funds from med A.I never had a patient or their
family want a review probably because medicaid was already paying the bill.Some of the
spouses were very confused when the request came to them,also sometimes some of the
reviewers were very persistent,sending several letters,also phone calls.
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