Under the insurance, you can use three forms of outpatient rehabilitation: procedures in the clinic, procedures in the day ward and procedures that are performed at the patient's home. When can a doctor issue a referral for rehabilitation? What kind of care are you en titled to and what treatments can you count on?

Outpatient rehabilitation under the National He alth Fundis available in three forms. The first isrehabilitation procedures , for which you come to the clinic. The second form is rehabilitation as part of a day ward, and the third - treatments that are performed at the patient's home. A he alth insurance doctor directs you to rehabilitation. The referral must include:

  • header stamp with the number of the agreement with the National He alth Fund
  • name and surname
  • PESEL
  • registered / residential address of the patient
  • recognition in Polish
  • disease entity code
  • description of a motor organ dysfunction, neurological deficit or other reason why we were referred for rehabilitation
  • Past and coexisting diseases and additional information (e.g. implanted pacemaker, metal in the body - endoprosthesis, drugs that may affect the course of rehabilitation)
  • ordered physiotherapeutic treatments with specification of the body area, side (right, left), as well as the number and doses of the recommended treatments.

The form must be stamped and signed by the referring physician and the date of the referral. The referral must be accompanied by a set of tests justifying the need for such therapy. The referral will expire if it is not registered within 30 days from the date of issue.

Outpatient rehabilitation in the clinic

Outpatient therapeutic rehabilitation includes medical advice and physiotherapy treatments. Consultation of a physician from a rehabilitation clinic is not necessary to start therapy. Referrals for certain physical therapy treatments, such as basic electro and magnetotherapy treatments, can be issued by any he alth insurance physician. The exception is patients with motor organ dysfunction caused by posture defects. In such a situation, a referral can only be issued by a doctor of a medical rehabilitation clinic or a doctor of an orthopedic or traumatological clinic.

Doctor referring to rehabilitation inon an outpatient basis, he may order no more than 5 types of procedures per day. Patients referred to physiotherapeutic treatments may benefit from a maximum of 10 treatments in one treatment cycle for one body area. If the doctor determines the need for long-term treatment of chronic diseases, he may issue a referral for 20 procedures.

Kinesiotherapy classes can be conducted individually or in groups or under the supervision of a physiotherapist, e.g. assisted exercises. Every patient who needs such a therapy and qualifies for it, can take advantage of 20 treatments in the cryogenic chamber within the framework of the National He alth Fund during the year.

After treatments or exercises, the patient signs a special form to confirm that the treatments were performed on a given day.

Outpatient rehabilitation in the day ward

If a patient requires longer rehabilitation or more intense exercise and treatment, and may leave home, he is referred to the day ward. This form of medical care is usually used by people after injuries, surgeries, chronic, neurological, rheumatological and oncological diseases.

The doctors of the departments of trauma, orthopedics, surgery, neurosurgery, rheumatology, oncology, urology, gynecology and internal diseases refer to systemic rehabilitation in the day center. In the case of exacerbation of chronic diseases, referral may also be issued by GPs.

This form of rehabilitation lasts from 3 to 6 weeks. Patients come to the clinic 5 days a week and spend about 4 hours here. During this time, they must have at least 5 treatments. Each day of treatment must be certified by the patient's signature.

Outpatient rehabilitation at the patient's home

Rehabilitation at home includes medical advice and physiotherapy treatments for various groups of patients, which is regulated by the Regulation of the Minister of He alth of November 6, 2013 (Journal of Laws of December 12, 2013). A referral can be issued by a he alth insurance doctor - a specialist in the field of: medical rehabilitation, balneology and physical medicine, rheumatology, neurology, orthopedics and traumatology, and a family doctor.

The referral must include a note from the doctor that rehabilitation is to take place at the patient's home. When qualifying for rehabilitation at home, the disease and the time elapsed since the onset of the disease are important. The National He alth Fund strictly defines who and how long can use this form of improvement. This group includes:

  • people with focal brain injuries (e.g. cerebral embolism, hemorrhagic stroke)brain injury, trauma) up to 12 months after the onset of the disease;
  • patients with severe damage to the central and peripheral nervous system (the degree of damage is determined on the Rankin 5 scale, which describes the degree of disability, the experienced ailments and dependence on the environment);
  • people with spinal cord injuries and spinal injuries up to 12 months after the accident;
  • chronic patients with progressive disease (myopathy, Parkinson's disease, polymyositis, spinal muscular atrophy, brain tumors, demyelinating processes (MS), collagen diseases, chronic extrapyramidal syndromes, rheumatoid arthritis;
  • suffering from degeneration of the hip (or knee) joints after endoprosthesis implantation up to 6 months after surgery;
  • patients with lower limb injuries (up to 6 months after the injury);
  • people in a vegetative / apalic state.

After visiting the patient's home, the physician of the rehabilitation clinic decides about treatment and determines the scope of exercises or treatments. The physiotherapist usually comes three times a week or more often if needed. Using portable devices, he can also perform, for example, electrostimulation or laser therapy. The patient or his caregiver confirm that the procedure has been performed with their signature.

Rehabilitation at home is usually conducted for 4 weeks. The National He alth Fund refunds up to 80 days of therapy per year. For longer rehabilitation, a written consent of the head of the NHF branch must be obtained. The doctor who submits such a request on behalf of the patient must justify it well, so that the patient does not meet with a refusal.

Important

Trust a specialist

In many rehabilitation clinics that have signed contracts with the National He alth Fund, you can take advantage of kinesis and physiotherapy treatments for a fee. It is worth remembering that even if you want to pay for rehabilitation out of your own pocket, you should ask your doctor to choose the right set of exercises or treatments for you. This is important because we are not able to choose, for example, the dose and time of exposure, and an unskillful list of treatments may undermine their therapeutic value. There are also many contraindications to using certain physical therapy treatments, e.g. atrial fibrillation, implanted pacemaker, cancer history up to 5 years after recovery, etc.

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