RETROSPECTIVE REVIEW SERVICE

If your family member or loved one has been in care for a period of time or if they have sadly passed away in care, we can help you to try and reclaim the care fees that they paid. This service is also based around Continuing Healthcare funding so we need to demonstrate to the NHS that the patient’s needs were at a level that would have met the criteria for Continuing Healthcare funding.

What Real:Life can do to help:

• Request records as necessary and review the case. This ensures that all of the available evidence can be reviewed by the NHS
• We will contact the local CCG (Clinical Commissioning Group) to instigate a retrospective review.
• We will complete any paperwork or questionnaires as requested by the NHS on your behalf.
• We will discuss with you in depth the NHS’ review documents before these are submitted to the NHS panel to ensure that these documents are a true reflection of the patients’ needs.
• We will attend the panel with you as your advocate if this is required. (Most MDT panels now sit closed but some CCGs offer a meeting before the MDT panel called a Pre-Panel meeting which we are invited to attend)
• We will chase the decision and advise of any next steps.
• If successful we will prepare and submit the proof of payments to allow for the NHS to calculate how much is due for reimbursement.
• If unsuccessful after the MDT panel, it may be possible for us to appeal this decision at either local level or to NHS England.

This service is offered on a ‘no win no fee' basis.