How to Get More Therapy After a Stroke

Many patients ask me how they can receive more therapy during the discharge process. In the past few years, insurance approval for therapy visits has significantly decreased, leading to an increasing number of stroke survivors being discharged too early. So, in this blog post, I will share three effective ways to get more therapy after your stroke.

So, you need more therapy after your stroke?

You have a couple options.

First, Try to Appeal the Discharge

If you have been informed that your therapy sessions are being discontinued, you can do a few things. First, you can try to appeal the decision to discharge. The discharge could be because your therapist believes you have achieved your maximum potential. In this case, you may consider finding a new therapist that specializes in neuro rehab. Alternatively, the agency or outpatient facility may end your visits due to a lack of coverage. If this is the case, you should receive a notice letter informing you that you no longer have authorization for therapy visits.

On this notice, there should be steps to follow to appeal the decision to discharge. Basically, this will reach out to a third party to review the case and see if you could still benefit from therapy. If so, you may get a few more visits. But most likely, it'll only be between 2 and 4 more visits. 

If you are not in therapy and are looking to start it back up, you have a couple of options. 

Option 1: Doctor's Order

To obtain therapy, ask your doctor for an order, also known as a script. Any doctor, nurse practitioner, or, in certain states, a physician assistant can write orders for therapy. If you are homebound, the doctor will arrange for home health services to come to you. If not, they will refer you to an outpatient therapy facility.

It is important to know that you have the right to choose where you receive treatment when obtaining a doctor's order. However, some doctors may try to limit your options by recommending a "preferred provider" within their hospital network. You should not feel obligated to go to their recommended provider, as the final decision should always be yours. To ensure the best outcome, it is a good idea to research which facility has the most qualified stroke therapists. Once you have identified the best option, obtain the facility's fax number so your doctor can quickly send over the order and start the treatment as soon as possible.

Asking questions about your stroke while at your doctor's office is essential to better understanding your condition. If you're unsure what to ask, refer to my blog post titled "10 Must-Ask Questions for Your Doctor About Your Stroke." These questions will help you understand your stroke better and increase your chances of recovery.

Option 2: Direct Access

The third and final way to get therapy is by direct access. This option is available in most states and allows you to go directly to the therapist to start receiving services without needing a doctor's order. However, in most states, some rules limit the number of visits or weeks you can receive therapy without a doctor's oversight. For instance, in Indiana, where I am located, it is 42 days or 6 weeks.

To find out whether your state allows direct access to therapy, you can quickly do a Google search. Direct access makes it easy for you to "shop around" and choose the outpatient facility, home health agency, or independent contractor to work with. When selecting a therapist, remember to look for those with neuro specialty certifications, as they are more likely to provide better quality stroke therapy than other specialty therapists.

Wrap Up

It is important to note that if your therapy has been terminated recently due to insurance denial, you may have to wait for 2-3 months before starting treatment again. This depends on your insurance policy, but you may need to wait a little while after your therapy ends before you can resume it. It's unfortunate, but it's the reality of stroke recovery. You'll have periods of treatment and then periods without it. Following the home exercise program designed for you, even when you're not in therapy, is crucial to keep progressing. This way, when you return to therapy, you can work on more advanced techniques to continue your recovery progress.

If you want more information on stroke recovery and want to follow guided exercise videos, check out our YouTube channel for guidance and assistance.

Also, take our stroke recovery success quiz to determine your chance of success if you don't change anything based on your lifestyle factors and current activity level. The quiz will also provide the next steps to improve your chances of recovering from your stroke.