Admission Process & Insurance to DCH Rehabilitation

Many of our patients have recently undergone surgery, been diagnosed with stroke, multiple trauma, spinal cord injury, neurological impairment, or have other complex medical issues that require acute hospital rehabilitation. Patients are admitted by a referral from a medical physician. To begin the referral process, please contact your medical physician or ask your case manager or social worker about consulting inpatient rehab.

Once patients are referred to the Rehabilitation Pavilion, a pre-admission screening is completed by one of our Rehab Liaisons to determine if patients meet inpatient rehab admission criteria based on Medicare and commercial insurance guidelines. This assessment includes an accomplished chart review and patient/family interviews that will be conducted in-person or over the phone.

Admission Process

Once patients are referred to the Rehabilitation Pavilion, a pre-admission assessment is given by an Admissions/Care Coordinator to determine if patients need the admission criteria based on Medicare and commercial insurance guidelines for medical necessity. This assessment includes an accomplished chart review and patient/family interviews.

• Patients must meet the following criteria to be a candidate for admission:
  • Require treatment from a multidisciplinary rehabilitation treatment team
  • Require, and be expected to participate in actively and benefit from, intensive rehabilitation therapy (3 hours a day, 5 days a week)
  • Be stable enough to participate in the rehabilitation program actively
  • Require rehabilitation physician supervision
  • Have a reasonable expectation of measurable, functional improvement or adaption to impairments
  • Be able to follow simple commands
  • Have a discharge plan or caregiver

Insurance

Admission criteria are based on Medicare and/or commercial insurance guidelines for acute inpatient rehabilitation admission. Coverage for admission is determined on a case-by-case basis. All insurances are accepted based on individual coverage listed on your policy. Stated benefit on your policy does not guarantee acute inpatient rehabilitation admission.

Please check with your insurance provider to determine if benefits for inpatient rehabilitation services are part of your individual policy coverage. For patients without primary Medicare insurance, precertification is used to determine justifiable admission for rehabilitation and may take 24 to 48 hours for determination by your insurance provider.