Outpatient Rehab?

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YoungM

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Dec 12, 2008
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Hi,

Does anyone have a recommended outpatient rehab facility in the northern NJ area? Does the visiting PT usually recommend an outpatient facility to you or do you need to locate one that is in your insurance?

Melissa
 
I'm sure you can get recommendations for outpatient rehab facilities from your surgeons office or the visiting PT. You do need to check to be sure your insurance will be covering it and can do that by calling your insurance company once you pick where you want to go. Unless you have an HMO, I would think any place recommended by a medical professional would be covered, but you may want to know that for sure.

I would advise choosing a facility that is close to your home. Getting to and from can be a pain (literally) if you have to drive any distance. You can check it out in MapQuest online too or checking the yellow pages.

Good luck, Melissa!!!
 
I was a double simultaneous THR. Everybody that I have talked to that did outpatient re-hab had a much longer recovery time and complications. I would highly reccommend inpatient re-hab to any hippie. I had my surgery on 12/22/08 and returned full time to work on 2/16/09. The therapists had me climbing the fire escape stair towers 7 days after my surgery.
 
Thanks Doublehippie. I'm actually getting inpatient rehab right now. My question was once the inpatient rehab is up, what's the process for continued outpatient rehab.

Glad to hear you were able to go back full time.
 
After my 2 week in home PT was over.....my OS
Gave me a prescription for outside PT, The timing didn't work for me because
We were driving down to Florida so I never used it at all!
Instead, -I made sure I did my exercises a few times a day
To make sure I kept myself moving!
!eing that you're so active, M....you can also do
Everything on your own as well! :)
 
Hi Melissa...

When I went for my 2-week post-op check up, my OS told me to "only" use a Sportscare Center from that same list of locations you had before online. Did you ask your OS if he has a preference?

I just got home from my 3rd visit there, and I feel amazing!!! First we did a heat wrap for 12 min, then the therapist stretched my hams and quads by pressing my legs away from the table---30 seconds each position. I let him stretch hard because I know how great it feels after. Then I felt brand new! Then I did the typical leg exercises on the table, and did some balancing on a wobbly wooden board, stepping using a step, and some resistance training with bands and cuffs around the ankles. When are you allowed to start outpatient?

Hop
 
I was scheduled to have outpatient re-hab as well but the therapist came to my house to evaluate me and said I did not need her and I just continued with my excercises on my own. I have to admit that I had an exceptional surgeon. His name is Dr. Andrew Star out of Abington Memorial Hospital here in suburban Philly. In 2008 he did 648 TKR and THR combined. My scars are only 3 1/2" long on both sides. He finished both hips in an hour and fourtyfive minutes. He could probably do it in his sleep. Best of luck with your recovery.
 
Unless you are independently wealthy, it's always wise to 1) check your insurance company's list of approved providers; 2) check if your plan requires pre-authorization for PT; and 3) check if your plan has an annual limit on number of PT visits. Take it from one who knows . . .
 
Unless you are independently wealthy, it's always wise to 1) check your insurance company's list of approved providers; 2) check if your plan requires pre-authorization for PT; and 3) check if your plan has an annual limit on number of PT visits. Take it from one who knows . . .

X2, good advice!
 
The rehab place I go to prefers "out of network" coverage, because by joining the insurance company's network, they have to agree to negotiated rates.
They claim that the 60% out-of-network coverage pays them much more than the 80% "in network" coverage, which is at a reduced negotiated rate.

So they take the 60% out of network coverage as payment in full, and do not charge the patient anything at all.

My OS prefers the 60% out of network over the 80% in network too.
 
Melissa,
Does your insurance pay 100% of rehab, or is it 80/20? Because when I had home visits though Bayada, the insurance paid 80% and I paid 20%, but with Sportscare, you pay nothing.....they take what ever the insurance pays out of network.
 
Of course you should check with your insurance...

My opinion is this - at home pt was great for what it was. Convenient, challenging and necessary. Now that you are starting to get stronger you need outpatient pt because it affords you a broader range of services, equipment and social interaction that at home therapy can't supply. I feel it is a natural progression. I loved my at home pt; he was wonderful and supportive, but I was ready for more. The place I go to is great - therapists are young, people are nice, equipment is current and going there is hard work but enjoyable.
 
For outpatient, I have a $25 copay each time. I am limited to 60 visits per calendar year. If in network, it's covered 100%, if out of network, then it's deductible & 30%. I checked on the Sportcare place and they do take Aetna. I haven't seen my OS yet to hear what he recommends, but I will ask him about that facility.
 
Did Sportscare tell you that they accept whatever the insurance pays, and they don't charge you any copay? That's what they told me.....I am just curious if it's the same with your location & insurance.
 
I had PT at Saint Clare's. They snagged me and signed me up (pending insurance approval) before I left the hospital. I had a very nice experience with all procedures very similar to how Hop described. Loved the heating pad and TED type machine. Got that done in the beginning and at end of each session. Also did a lot of exercises lying down, leg lifting with weights, stretching and bending. I remember that the hardest exercise was lifting my leg straight up. Of course now it is a breeze---muscles come back nicely.

I went to PT 2-3 times per week until I went back to work at 8 wks. Got approved by insurance to go a few more sessions but couldn't fit them in once I got back to rat race and knew I could do the flex exercises at home. (Was already getting back to World Gym too.) Of course I didn't do the exercises as much as I should have. That is the area that is still not great...though now with some effort I can sit cross legged for first time in probably 20 years.

My insurance, Horizon BC/BS, covered everything--no co payment. (perk of working for the County).

Laurie
 
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