Author Topic: Doubt this could happen in the UK  (Read 100 times)

JLR2

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Doubt this could happen in the UK
« on: August 19, 2018, 04:33:55 AM »
As I have mentioned my friend in Berlin recently lost her father, his dying on the 4th of August, over the past few days I have been speaking with her (pretty much all I can do as I'm unable to leave the country again for a while) about how she is managing.

One of the issues that has come up is in relation to services he received whilst in the care home for a few weeks. Under the German system and through the insurances my friend's father had in place he was able to receive a service called 'Ergotherapy'  a physiotherapy which although in the main would be covered by his insurances there was still a portion that he would have to contribute. Well the physiotherapy company has sent my friend their bill for the services her father received, a bill not far short of 700 euros. One of the problems with this bill, which also gives the dates when an ergotherapist visited her father in the care home, is that the company providing the service has claimed to have provided the service on the 3rd of August. On the 3rd of August the man was in hospital dying and under the German health system no therapies such as the one being provided by the physiotherapy company are allowed so that means the claim is wrong.

It is not just this one day of the physiotherapy company's claim that is out of order, they have also claimed for days when though my friend was with her father virtually all day and no ergotherapist appeared to have been at the care home they still put a claim to say they had been there. Going by what I myself saw of my friend's father condition I doubt anyone could engage with him to do any sort of physiotherapy related exercises. To give an inkling as to how bad things were it could take my friend up to 2 hours to spoon feed her father a small tub of yogurt. The majority of my friend's father's day was spent sleeping, he was confined to his bed for all the time he was in the care home as his health never improved to the point where he could be moved to his wheelchair again. The picture that sticks with me of the last time I saw my friend's father was of him sleeping open mouthed looking to the left of the bed he was in. He was completely oblivious to the world around him for much of the time he was there so the idea that any sort of physiotherapy was going to benefit him is something of a joke.

I don't know if there are private companies in the UK who provide such physiotherapy services in UK care homes and would wonder if they, like the one involved in what I have been talking about, make spurious claims for services they never actually provide? 

It may be possible through the paper trail, if I can put it that way, that my friend can show proof that the physiotherapy company is making claims for services they have never provided but surprisingly one of the problems in sorting out things is the lack of help from the insurance companies involved as even though they will pay the bulk of a claim and therefor stand to lose most money they apparently tend not to question the bills they pay out on as, from what my friend has explained, they find it too costly to question the bills. Just seems that between the companies providing services to care homes and the insurance companies they look on dementia sufferers as cash cows. The insurance companies due to the German system have more or less a captive market, folk have to pay their health insurance, and companies such as the one involved in my posting count on dementia sufferers being unable to explain to their families what's been happening from one day to the next. Many families of dementia sufferers in care homes are unable to visit their relative (father/mother)  as often as they would want to due to their own work commitments and looking after their children and it is this that many companies in the car home sector are exploiting. Unfortunately for the physiotherapy company and the care home involved in my friend's father's case my friend was able to visit her father and did so every day for many hours each day, even when I was over recently, so they cannot hide things so easily including explanations as to why various staff at the care home signed off ergotherapist visits to my friend's father when no therapist turned up.

Sorry my posting is so long but I feel a bit better this morning for having posted it now.
« Last Edit: August 19, 2018, 04:44:53 AM by JLR2 »

Fiz

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Re: Doubt this could happen in the UK
« Reply #1 on: August 19, 2018, 10:02:21 AM »
Will this bill be covered by the insurance company? If so I'd include a letter stating that she was with her father every day between X and y and therefore no physio could have been completed during those times and that she believes the bill to be inaccurate.

Did you friend order the physio or sign to say she would fund it? Otherwise I can't see how she would be liable to pay the bill and why it was sent to her.

I expect medical services are very different than in the UK so apologies if my questions are totally irrelevant or inappropriate.

JLR2

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Re: Doubt this could happen in the UK
« Reply #2 on: August 19, 2018, 02:16:53 PM »
Hi Fiz, the way things appear to work in Germany sees folk making some kind of percentage contribution. Quite how much this contribution is I don't know there are however other issues with the physio company involved.

When my friend approached the physio company's office near where she lives they told her it was another branch, the central branch in the city, that deals with home or care home visits and that she would have to ask them about her concerns. Odd then that the billing that she has received is on the local office's headed paper rather than the office in the city's paper. In effect they are trying to give her the runaround, it is things like this that has me so frustrated as were I in Berlin now I would wipe the floor with these people.