Referring to Rehab Without Walls® : Helpful Guidelines for Physicians

Alternatives January 22 by RWW

Timing

Call as early in the process as possible before the patient’s discharge. Unlike home healthcare in which the timing between referral and start of service can be less than 24 hours, Rehab Without Walls® first will perform a patient assessment to determine if our model of care is suitable for the patient, meet with the patient and family often while the patient is still hospitalized, put together an initial plan of care, and work with the insurer to obtain the necessary authorization. This may take a little more time upfront. However, this also means that when the patient is discharged to home, an interdisciplinary treatment team is in place, functional goals have been set, the family is keyed into the rehabilitation process, the home has been assessed for safety, and the patient can make a smooth transition from an inpatient facility to home to begin treatment immediately. A good rule of thumb is to allow a week between referral into Rehab Without Walls® and discharge. We realize, however, that is not always possible and we do everything we can to work quickly and within the patient’s timeframe.

Contact Information

Talk directly with the admissions manager at the location you are referring into. If that location does not have an admissions manager, the person answering the phone will direct you to the correct person. If you are unsure whom to contact, call Rehab Without Walls® ’ general toll-free number at 1-866-734-2296.

Diagnoses

While it is true that Rehab Without Walls® is not for everyone, it is equally true that the individuals for whom Rehab Without Walls® is appropriate return to their lives with maximum functionality and independence with durable outcomes. Rehab Without Walls® specializes in complex neurorehabilitation, however, our treatment model is highly effective for a number of other conditions (see box at right), especially complex cases that need intensive, comprehensive treatment. Some general patient criteria for Rehab Without Walls® :

  • The patient should be medically stable
  • The patient should show clearly definable rehabilitation potential
  • The patient’s condition is manageable and does not require inpatient care
  • There is a family or support system in place in the patient’s home

Patient Information

For all potential referrals, the physician’s office needs to first send the patient’s insurance information so we can verify benefits. If the patient is hospitalized, physicians need to send an order to evaluate so that a Rehab Without Walls® representative can go into the facility, get a release signed by the patient or guardian and review the medical records.

Insurance

Rehab Without Walls® works very closely with payers to help them understand what our program does and how it creates effective, durable outcomes. Depending on the diagnoses and the parameters of the insurance plan, we have been able to apply the outpatient, home health, SNF and even the inpatient benefit toward Rehab Without Walls® . In addition, because of our focus on returning patients to functional, productive lives, we frequently work with workers compensation cases.

A Few Things Physicians May Not Know About the Rehab Without Walls Approach

  • The referring physicians become part of our treatment team and may participate in ongoing meetings and evaluations as needed.
  • There is just one point person to communicate with—the clinical coordinator on each case.
  • Rehab Without Walls® is not a Medicare model with therapies based in 15 minute increments. It is an intensive, structured program that can deliver as much as six hours of interdisciplinary care daily, depending on the needs of the individual served.
  • Our comprehensive approach includes things like working with the patient and family on stress management, accompanying the patient on doctor’s appointments, helping a child return to school, and working with an individual’s employer on-site to facilitate a smoother return to work.
  • We can perform in-service presentations at hospitals and physician’s offices to further educate medical professionals on how Rehab Without Walls® can best serve them and their patients.