I have a patient diagnosed with glioblastoma. She has private insurance. Insur approved 27 visits for SN, 27 for PT and 27 for OT. She is homebound, she cant walk or use the left side of her body. Our PT are NOT aggressive AT ALL, they hardly do anything in the home. This patient is wanting to be involved in a clinical trial, one of the requirements is to be mobile...so she is going to go to OP therapy once per week (they have equipment and are working really hard with her to try go get her more mobile so she can get into this clinical trial). Her husband is having to take off work this one day to take her. My problem is, Im worried that her insurance will now consider her no longer homebound, but she really is. I go only when necessary so I can conserve the visits for necessity. She has a PCA pump, decubitus on her coccyx, has multiple med changes that require ALOT of teaching. Our insurance dept was supposed to let me know today, but I havent heard anything from them. Im soooo worried about this patient. She has SMALL kids and she cries all the time. She is truely depressed (understandable). She is not wanting hospice because she feels like that is "giving up", but she is palliative. If insurance denies anymore SN visits, Im going to call them personally and discuss this with them. Its a REAL hardship for her to get out of the house. She cant stand or walk without total assist. What can I say/do that will maybe make the insurance reconsider? They havent denied yet, but I have a feeling that they will. I know that with Medicare, you cant continue if they receive any outpatient tx's, but she has private insurance. Anyone else ever have a situation like this? There is such a fine line with being homebound and patients like this fall into the cracks.