I recently visited a member of my church who has been denied physical therapy. She is 65 years old and feels that PT will allow her to strengthen her legs enough to help her stand up. Her desire is to walk again. Are there any pro bono therapist organizations available to assist her?
There are many reasons she is being denied. Primarily, her insurance won't pay for it for the reasons already mentioned. It also could be she is Medicaid pending. Meaning she has no money to pay for her care. So Medicaid has been applied for. This takes a few months to process and in that time the facility is not getting paid so this woman is only getting the basic care. Therapy will not be given until Medicaid starts paying again.
I am sure this woman has been told why she is not getting therapy. Even if you could find someone to give her therapy for free, the facility does not have to allow them on their property. Its really hard to understand Medicare and Medicaid if you aren't collecting it yet or if are collecting, have never really not had to use it. Me, I really have not had to use it for Rehab and therapy, but my Mom did and as her POA I handled the billings. Its a learning experience.
There are range of motion and daily excersices offered too. It is up to the patient to participate. The facility can not make them do anything per regulations. They can facilitate the importance of wellbeing.
And, of course it costs money for PT and it is billable to insurance. If results are not occurring insurance will deny. Revenue is necessary for facilities to remain open.
There may be opportunity have PT as a selfpay. It usually is $150 -$300 per hour out of pocket.
That raises the question of why wasn’t progress being made? Often it’s because the patient didn’t want to make the effort. My cousin had shoulder surgery and recovered fully; her doctor said that most people don’t recover that well for the simple reason that they don’t want to follow therapy guidelines and/or quit too soon. The patient may not want to admit this and then complains that “the doctors didn’t do a thing to help me.”
Also, a person with cognitive difficulties doesn’t understand or remember how to do PT. The therapy will be stopped by the therapist after working with them for a while and getting nowhere. My mother thought her PT was Elvis and they were going to get married. My father thought the hospice pastor was his PT and told him to go away.
There may be more to why your friend’s therapy was discontinued than she has told you.