July 23, 2025

Taken Care of in a Timely Manner

Yesterday I found it concerning that when I finally called the right number for Medicare and asked about whether or not Mom’s new benefit period began now that she has been home (with no additional inpatient admissions) for over 60 days as required for her plan to reinstate a new series of available Medicare Part A days.

The representative I spoke with yesterday seemed more knowledgeable and professional than some others I have spoken with in the past and she was able to tell me that her view of the system shows that Mom’s days should have come back now (other than those 60 lifetime days which never come back) given that I did understand correctly that she has been home for more than 60 days.

However, this helpful representative admitted that though Mom should be in a new benefit period as of a few days back, the system does not show the availability of the new days on her end.

Ok, so I am of course glad at this point that this representative is confirming for me what we suspected that Mom FINALLY was able to stay home for 60 plus days in a row without any inpatient admissions and her Part A benefits are returning in time for an upcoming surgery that is scheduled for Monday at the big hospital.

So I explained to the helpful representative that the surgery is supposed to be first thing next week and I would like to confirm that her Part A benefits are reinstated now for a new benefits period as she has met the requirements. The helpful representative replied that she was escalating this to what I believe she called a “senior specialist”. She assured me that she was writing a thorough explanation of my question and the reasons for my question and I believe that she did. t

Here’s what led me to feeling concerned yesterday. The helpful representative told me that the senior specialist had 7 business days to return my call. 7 business days?! It was Tuesday and the surgery was Monday!

I expressed this concern to the helpful representative and she said that I could call Mom’s surgeon’s office and encourage them to call the provider line for confirmation.

Seriously, how are patients, especially Seniors, doing all of this without someone advocating for them through plenty of inefficient steps?

I thanked her and asked for her name. She gave it to me and I asked for her extension. She said she doesn’t have an extension or a call back number and I can just call the main number back and explain all of this again if the senior specialist does not return my call before the 7 business day window.

Not an ideal option, but grateful to know that’s the way it is for future reference. So yesterday I called the big hospital’s outpatient surgery office and explained everything about the potential billing concerns if the new benefits period is not clearly started in the system. The woman who answered the phone listened to my whole explanation and then had to transfer me to a woman in the billing department whose voicemail answered my call. I explained everything yesterday on her voicemail and have not received a return call from her.

It seems, this time, that all is working out for Mom. I was absolutely shocked and thrilled that the senior specialist returned my call today and I was available to answer right away! She couldn’t have been nicer and did confirm that Mom’s Part A is in a new benefit period as of a few days ago when Mom made it to 60 days at home without an inpatient admission during that time.

Thankful to have that verbal confirmation and when we got disconnected because I am traveling and was on the road when she called, she called back and left a message trying to finish our call. Very kind of her to call back! Unfortunately I didn’t have reception and her message stated that I would just have to call the main number back again. No direct number or extension to call her back and finish our call.

Grateful that I got what I needed at this time, but quite frankly I am waiting for the other shoe to drop.