Pre-Admission Case Management

A pre-admission case manager phoned with a few questions relating to post-surgery rehabilitation:

1. Does my home have stairs to get in?
2. Does my home have stairs inside?
3. Is anyone at home to help me?

She told me that screening nurses from two of the local rehabilitation centers (Helen Hayes in Rockland County, and Burke in Westchester County) are on-site daily at HSS.

Admission to one of those facilities will depend on approval by my health insurer (Oxford) and availability (room at the inn).

I understand that, from a patient's perspective, rehabbing at one of those facilities is much preferred to rehabbing "at home" or even at a nursing home with rehab capability because of focus, expertise and frequency of rehab exercising.

However, sometimes (?) a health insurer case manager might have a different view as to "medical necessity". In my case, with both hips being replaced, HSS' pre-admission case manager is of the opinion that I should have no trouble getting insurer approval. I'll let you know.

I am told that sometimes advocacy is called for. I'll have to see if anyone I know is skilled at that. ;-)