Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Denied 2nd Night Hospital Stay For Gastric Sleeve!



Recommended Posts

I was sleeved on Nov. 1st, and it is standard per my surgeon for a 2-night stay in the hospital. I got a letter this weekend from United Health Care, stating that they are denying coverage for 11/2 on in the hospital. The letter states that the second night's stay was not medically necessary since I did not have a fever, complications, bleeding etc. etc.

Has anyone else experienced this and how did you resolve it?? I certainly cannot afford a whole day and night's hospital bill, that's for sure! Any insight would be greatly appreciated!

Share this post


Link to post
Share on other sites

Something doesn't sound right. Everything should have been approved prior to surgery. The doctor's office should have worked out the details about how long the hospital stay was scheduled for and gotten it approved before setting a date. I don't know about these things except from other people but if it were me, I would get in touch with the doctor's insurance coordinator first.

Good luck. Paying for an overnight stay at the hospital would suck because then you would have to pay for any and everything they gave you from pain meds to IV fluids to meals to toothpaste!

Keep us posted.

Shae

Share this post


Link to post
Share on other sites

I would start with your Dr's care coordinator they had to have submitted paper work for pre authorization. If a two night stay is your Dr's standard of care they must know this. Also, who gets to decide what's medically necessary? I would ask your Dr why he made the decision he did, he obviously felt it was necessary and might give you some info to go to the insurance co with. Good luck.

Share this post


Link to post
Share on other sites

Wow that sucks. I hope I don't have that problem because I spent 4 nights in the hospital.

Share this post


Link to post
Share on other sites

I concur with the advice already stated here. Aetna only pre-approved a 1 night stay also, but I ended up staying 2 nights. I knew that going into surgery and so when they wouldn't release me after 1 night due to not getting in enough fluids and such, I made sure to talk to someone from their admissions to be sure they were on top of this. What they told me is that they would be submitting contacting Aetna that day to let them know why I wasn't being discharged and that it wouldn't be a problem. I made it clear I couldn't afford a 2nd night stay on my dime.

I didn't have any issues with the billing thank god, but I did worry for a few months that I would start getting misc. bills on this. Aetna told me that after surgery, the hospital has up to 6 months to submit bills, so technically I have 1 more month before they could sneak something in, but I'm hoping that won't happen.

The key is did your Dr.'s office or the attending Dr. while you were at the hospital do the proper paperwork/ insurance approval for the 2nd night. Your in a vulnerable position after having surgery and should be able to rely on the medical professionals to know what needs to be done in these situations.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • BeanitoDiego

      I've hit a stall 9 months out. I'm not worried, though. My fitness levels continue to improve and I have nearly accomplished my pre-surgery goal of learning to scuba dive! One dive left to complete to get my PADI card 🐠
      I was able to go for a 10K/6mile hike in the mountains two days ago just for the fun of it. In the before days, I might have attempted this, but it would have taken me 7 or 8 hours to complete and I would have been exhausted and in pain for the next two days. Taking my time with breaks for snacks and water, I was finished with my wee jaunt in only 4 hours 😎 and really got to enjoy photographing some insects, fungi, and turtles.
      Just for fun last week, I ran two 5Ks in two days, something I would have never done in the past! Next goal is a 10K before the end of this month.
      · 0 replies
      1. This update has no replies.
    • Teriesa

      Hi everyone, I wrote back in May about having no strength. I still get totally exhausted just walking from room to room, it’s so bad I’m using a walker with wheels of all things. I had the gastric sleeve Jan. 24th. I’m doing exactly what the programs says, except protein shakes. I have different meats and protein bars daily, including vitamins daily. I do drink my fluids as well.  I go in for IV hydration 4 days a week and feel ok just til evening.  So far as of Jan 1st I’ve dropped 76 lbs. I just want to enjoy the weight lose. Any suggestions or has anyone else gone thru this??  Doctor says just increase calorie intake, still the same. 
      · 0 replies
      1. This update has no replies.
    • Stone Art By SKL

      Decorative Wall Cladding & Panels | Stone Art By SKL
      Elevate your space with Stone Art By SKL's decorative wall claddings & panels. Explore premium designs for timeless elegance.
      · 0 replies
      1. This update has no replies.
    • Clueless_girl

      Losing my hair in clumps and still dealing with "stomach" issues from gallbladder removal surgery. On the positive side I'm doing better about meeting protein and water goals and taking my vitamins, so yay? 🤷‍♀️
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      I've hit a stall 9 months out. I'm not worried, though. My fitness levels continue to improve and I have nearly accomplished my pre-surgery goal of learning to scuba dive! One dive left to complete to get my PADI card 🐠
      I was able to go for a 10K/6mile hike in the mountains two days ago just for the fun of it. In the before days, I might have attempted this, but it would have taken me 7 or 8 hours to complete and I would have been exhausted and in pain for the next two days. Taking my time with breaks for snacks and water, I was finished with my wee jaunt in only 4 hours 😎 and really got to enjoy photographing some insects, fungi, and turtles.
      · 1 reply
      1. BabySpoons

        Amazing! Congrats!!! Watch out for the sharks. 🦈

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×