We recently helped a family receive a £26,300 refund of incorrectly paid care fees; this is how…
As a company, we have a high success rate of assisting individuals in securing continuing healthcare funding, both on a retrospective basis (securing refunds of fees that should not have been paid), and securing funding on an on-going basis from day one and we recently helped a family receive a £26,300 refund of incorrectly paid care home fees.
Following a Decision Support Tool assessment completed in hospital in December 2015 which Mr A failed (he was awarded Funded Nursing Care rather than NHS continuing healthcare) the client contacted Compass CHC to see if we could help.
Prior to his hospital admission, Mr A was living at home with his son however upon discharge, the hospital stated that his condition meant he had to be put into a care home upon leaving their care.
Unfortunately, the complexity of his condition meant that suitable care homes were quoting up to £3000 per week. Mr A spent 3 months in hospital (he was still in hospital in March 2016, 3 months on from his initial admission and assessment) but in mid-March 2016 he was discharged to a care home.
We instigated an appeal as we felt, after reviewing the evidence, that the Decision Support Tool findings were incorrect and that Mr A met the criteria for NHS continuing healthcare funding. In February 2017, the continuing healthcare team confirmed, having considered the formal written representations submitted by Compass CHC, that the DST of December 2015 had been overturned and Mr A was eligible for funding from 11.03.2016 to 13.06.2016.
A new CHC assessment was then undertaken on the patient on the 28.06.2016 where full NHS continuing healthcare funding was awarded again.
We then argued that the CHC funding should be in place for the entirely of the period from 11.03.2016 to 27.06.2016; the CCG confirmed this to be correct and amended their recommendation.
As a direct result of the interventions made and negotiations conducted by Compass CHC we secured a £26,300 reimbursement of fees for the patient.
Should you, or a relative, have any concerns regarding NHS Continuing Healthcare funding, or you are thinking about starting the funding process, our expert advisors can assist by explaining the ins and outs of what can be a perplexing and complicated process. There is no time limit placed on this free, no obligation consultation. Should you wish to discuss matters further, do not hesitate to contact us directly on 0121 227 8940