It shouldn't make a damn bit of difference when rehab is started! COMPETENT? DOCTORS WILL HAVE EXACT PROTOCOLS FOR EVERY SITUATION!
This situation is completely for the doctor to resolve! Pure incompetence of the doctor and hospital; no excuses are allowed!
Why a Michigan man waited over a month in the hospital for stroke rehab
When John Karadell was admitted to the hospital after a stroke, his doctors quickly pushed for him to begin an intensive form of rehabilitation — the sooner the better.
“Almost immediately they started telling me that the No. 1 most important thing now is to as quickly as possible get me into what they call acute rehab,” said Karadell, 58, of Howell, Michigan. “They used words like, ‘This is crucial. This is essential to your recovery.’”
But after 11 days in a hospital bed with no word on when he’d be transferred to the facility, Karadell said he learned his health insurer, Aetna, had denied coverage for what’s known as acute post-stroke rehabilitation.
What followed was a weekslong back-and-forth between Aetna and the hospital, University Hospital in Ann Arbor — including phone calls, bureaucratic delays and miscommunication, according to a Michigan Medicine spokesperson, an Aetna spokesperson and hospital case notes reviewed by NBC News.
More than a month after Karadell’s stroke, he said he essentially gave up and left the hospital to go to a less-intensive rehab program, a downgrade from what his care team consistently recommended throughout his hospital stay.
“I’m left with what I believe is permanent damage,” Karadell said. “And I’m left to wonder: Could it have been different if they would have approved what they should have done?”
In a statement, an Aetna spokesperson said the circumstances surrounding Karadell’s denied claim are “complex” and the insurer’s ability to process claims and appeals is “dependent on the timeliness and comprehensiveness of the information we receive from the provider.”
“We understand the frustration whenever there is a health care process that is complicated or does not meet a member’s expectations,” the spokesperson said. “Even though the vast majority of experiences are managed smoothly, our company strives to partner with healthcare providers to make sure each member receives what’s expected every time.”
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