Has anyone gone to a skilled nursing facility after heart valve surgery. I will need to go since I don't have 24 hour care at home. For those who did, did ...Read more
Has anyone gone to a skilled nursing facility after heart valve surgery. I will need to go since I don't have 24 hour care at home. For those who did, did you research places ahead of the surgery or wait until after the surgery? I can't imagine waiting until later. What was your experience like?
Catie B I didn't receive in-patient care after my hospitalization. But while helping older family members in ... Read more
Catie B I didn't receive in-patient care after my hospitalization. But while helping older family members in the past, I've understood that they usually won't coordinate a move to a rehab facility ahead of time, because they have to certify that you're needing that assistance as you approach discharge. For sure, bring it up with your surgeon. Once you know which hospital you'll be in, I would suggest calling and speaking with their social worker about how they coordinate their transitions.
Cathy Zuber Hi Angela, Catie has good points re Docs having to say you need the extra care. Insurance needs to k ... Read more
Cathy Zuber Hi Angela, Catie has good points re Docs having to say you need the extra care. Insurance needs to know. For myself, I did discuss my options with some friends that are nurses before I had my surgery. In my case, a nearby hospital ( about 3 miles from where I had surgery) is known for their rehab care. 40 + rooms on 2 floors for rehab after various surgeries. That is where I went for 10 days after I was discharged from my hospital. Early research does help. Ask your docs, too. They are familiar with facilities in yr area. Best wishes!!!
Scott Killian I'm interested too. Alone at home after this would be daunting.
Lynda Ruiz Having had knee and hip replacements a year apart I was familiar with the protocol for qualifying for ... Read more
Lynda Ruiz Having had knee and hip replacements a year apart I was familiar with the protocol for qualifying for rehab. I live alone and requested it to get daily physical therapy for knee & hip. I also live on a gnarly dirt road that home care might have a problem with. Both times stayed about a week before what they called "early release. Fast forward to open hear surgery in another state near family. They all assumed I could just "request" rehab. As I was going to recover at their home, they feared my needs. I was 8 days in hospital and the social worker explained I did not qualify as I could walk unassisted (including cane & walker). My sister drove mew to my dad's for showers as he has walk in shower with several handrails. I did not need assistance, but did have home health care for 2 weeks.
Angela Reynolds I appreciate your comments. I will remember that if I need to schedule SAVR. I was accepted into a ... Read more
Angela Reynolds I appreciate your comments. I will remember that if I need to schedule SAVR. I was accepted into a clinical trial and was approved to get a TAVR instead. However my insurance company, United Serviceman's Family Health Plan wouldn't approve it. And my procedure is scheduled for next Tuesday. I haven't finished my profile since I don't know whether I'll have it now or not. The insurance company wouldn't answer the question, "Do ypu approve any TAVR's? So I'm so mad--all I want to do is be an anctivist, to fight for all of us who are getting prohibited from having the surgical procedure of their choice. The rest of the story is below.
I am still awaiting authorization from my insurance company for a 2nd consultation with a 2nd surgeon. The first surgeon was time crushed and I didn't get all ...Read more
I am still awaiting authorization from my insurance company for a 2nd consultation with a 2nd surgeon. The first surgeon was time crushed and I didn't get all my questions answered. And some questions about recovery from aortic valve replacement were responded with "after the surgery I'll discuss it". I want more answers now, not while I'm drugged up after surgery. Anyhow my cardiologist was not pleased because I wanted another consultation. He scheduled two tests however, a cardiac catherization test and a carotid echogram. He wants to check for coronary or carotid artery blockages or narrowing.
Judy Stokes You deserve answers, don't let them take that from you! Stand your ground
Marie Myers Does the first surgeon have a PA or Nurse Practitioner that could at least answer questions for you? ... Read more
Marie Myers Does the first surgeon have a PA or Nurse Practitioner that could at least answer questions for you? Many surgeons have someone working with them that knows their routine and how things go. Your questions should be answered.
Steve Farthing Get all the consults you want. Ask lots of questions. Very useful.
Angela Reynolds I did get an authorization to see the 2nd surgeon. However, it took some time initially because the o ... Read more
Angela Reynolds I did get an authorization to see the 2nd surgeon. However, it took some time initially because the only surgeon my insurance company would accept was too far away, in Westchester County, NY when I live in New Jersey. So after a few days I was approved for the first consult after calculating the distance. And I eventually got approved for the 2nd surgeon after explaining my reasons for a second opinion. So my next question is: How do I get approved for a TAVR? I was already denied because I am high risk based on the diagnosis (severe aortic stenosis) but low risk for the TAVR because there are no other contraindications. And because the doctor who requested it did not consider it medically necessary. It just doesn't make any sense to me.
I went to the 2nd surgeon for a consult but he only does the SAVR Surgical open heart surgery. Since I had no other medical problems, he recommended I might consider enrolling in a trial for the TAVR, which I did. It was never mentioned that medical insurance may not cover it. And Columbia Presbyterian Hospital never had me talk to the billing department. Yet I had to register first in general in the hospital, then before any testing in the Lab, X-ray, etc. And none of them informed the billing department that I had two insurances, Medicare, and a military retired insurance, United Serviceman's Family Health Plan. The surgery was all scheduled and my family out of town made flight reservations and I arranged for a room in New York instead of commuting there in the morning of the procedure. Now I get the shock of my life. And I wouldn't have found out unless it suddenly occurred to me that I should ask for an authorization for the surgery. I thought I was blessed being approved by the hospital for the TAVR. I have been calling back and forth and the Hospital is telling me just to wait. They're working on it. And I've only been able to talk to the PA. A different doctor will be doing the TAVR, one has been doing it for 10 years and has the experience, DR. Komali.
Does anyone have advice what to do? This is the first time I've had to fight to get approvals or to beg to get information. And I still don't have it.
Judy Stokes Have you had surgery yet? Keep us updated
Angela Reynolds After I was accepted for the TAVR trial a date for the surgery was scheduled for August 15th, 2017..H ... Read more
Angela Reynolds After I was accepted for the TAVR trial a date for the surgery was scheduled for August 15th, 2017..However the Thursday before the surgery I requested a review of my insurance. When I called my insurance carrier at the time (my military insurance) they denied covering the operation because it was not proven. So, to make a long story short, I received four denials from my insurance but found out that Medicare would cover it, but only 80%. When I spoke to Columbia's billing department, they wanted me to pay $13,000 upfront with total cost being about $65,000 all together. So if it was more, I would be billed later. So considering that I didn't know yet about additional doctor's charges, etc. I decided not to pay the 20% out of pocket. Also Columbia would not agree to any sort of payment plans to help me with the expenses over time. I was disappointed because I really wanted the TAVR. I was in good health, otherwise, so I figured there would be no complications. I fear that there may be complications after the SAVR unfortunately. So then I decided to switch my military insurance to Tricare 4 Life since Medicare is the primary payer while US Family Health Plan was not. So in the meantime I ordered zippered compression stockings to help me later, a mechanical lounge chair to put in my dining room so I am near the bathroom and kitchen, and a device to fit over my chest to prevent irritation of clothes on my surgical site. I am also cooking and freezing meat, rice, vegetables, to make it easier to prepare meals later. I was also very depressed and anxious since July 21st, 2017 with all the calls, denials, changes, planning, etc. that I saw a psychologist. I'm trying to get Zoloft but now I need to see because the psychologist says maybe I can't take it before the operation. I see my medical doctor on October 4th. Since my birthday is October 1st I decided to volunteer 3 times before my operation with Compassion. I need to take my mind off the operation and the pain afterwards. I feel anxiety just writing this piece so I hope I can inspire someone. I made one appointment with Upper East Side Rehabilitation Center on East 79th Street in NYC for one suggestion for aftercare. They were optimistic because they take patients from Columbia Presbyterian.
Jennifer McInerney I am from Canada and we have universal healthcare. I find it completely unacceptable that you have to ... Read more
Jennifer McInerney I am from Canada and we have universal healthcare. I find it completely unacceptable that you have to deal with denials from insurance companies at a time when you are already stressed and anxious with a valve issue. Our system isnt perfect. We have wait times for non essential surgeries but at least we arent fighting with insurance,