Is it against the law to have a patient pay a nursing home bill if the nursing home didnt get pre approval to switch the patient from hospice to skilled nursing?
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Is it against the law to have a patient pay a nursing home bill if the nursing home didnt get pre approval to switch the patient from hospice to skilled nursing?
My mom was put in a nursing home under hospice but she
got well enough to take her off hospice and into skilled
nursing with the intent of bringing her home. All of her
therapies were paid but her room was not because there
was not pre approval to move her from hospice into skilled
nursing. The insurance company says that the nursing
home dropped the ball and they were well aware that there
should have been pre approval and that it is against the law
to put that amount on the patient. Is this fact?
Asked on June 25, 2018 under Business Law, Pennsylvania
Answers:
SJZ, Member, New York Bar / FreeAdvice Contributing Attorney
Answered 6 years ago | Contributor
No, it is not against the law, the same as it is not against the law to have a patient pay an emergency room, a hospital, a clinic, a doctor, etc. bill if it was not pre-approved or otherwise covered. A patiient is liable for his/her medical or nursing home costs; if the patient incurs the cost before confirming that they are approved for the service or that the service is covered by some form of insurance or payment source, the patient is resonsible for the bill.
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