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Posted: Wed Sep 05, 2007 1:46 pm Subject: Hospital co-pays

I know this is small in the big picture but we took our daughter to the hospital twice in 25 hours.
One was right before midnight and one was right after midnight so it looks on paper like it was 2 days apart when it was really 1.

We took her twice because the first time they discharged her when she seemed okay for about 15 minute and just a few hours later was kept getting worse and worse until she was almost unresponsive.

The hospital billed it as 2 separate visits which it was but for the same thing.

Has anyone argued with a hospital over co-pays and won?

I am fine with paying 1 co-pay but really do NOT want to pay both when all they did was insult me, have us wait in the WAITING room for 8 hours ad give her 1 dose of Motrin (which was not working in the first place).

Then I had to take her for a follow up and the doctor said she had a bad ear infectiong WHICH the hospital never caught!
I am just boiling!

Posted: Wed Sep 05, 2007 1:51 pm Subject:

sorry to hear about this - I've been there with the ear infections with my own sons, so I know what you're dealing with.

Unfortunately, from an insurance standpoint, any visit where you leave the hospital (with discharge papers)& then return is considered a separate visit, and will be billed as such - even if it's on the same day. It stinks, I know, especially when you will have prescription costs added into it, and a follow-up visit as well.

Posted: Wed Sep 05, 2007 2:08 pm Subject:

I know what you mean, but it is probably going to cost you more in time and trouble, than the whole thing is worth. You really cant win with these insurance companies.

Posted: Wed Sep 05, 2007 2:19 pm Subject:

I called the insurance compnay first because I thought they might be able to help and they said they could do nothing but what I could do is see if they could bill it all as one treatment.

I was transferred all over and then given a number to call someone who is supposed to help 'the people' and it took 1-1/2 weeks to get through to her. It has been almost a week since then and no word back yet.

Posted: Wed Sep 05, 2007 7:09 pm Subject:

I actually do hospital billing. If the actual date of service/admission is the same, it should only be billed once. However, if the the first date of service/admission is say 10pm 09/04 and dishcharged at 11:30opm the second admission is 09/05 at 12:02am there will be 2 separate bills. Not because the hospital wants more money, they have to bill it that way, especially to the insurance company. If the faciltiy alters their claims to reflect a one time admission it's technically insurance fraud. You can be admitted as many times as you need to be in one day, but as soon as the clock strikes midnight, it's a second bill.

Posted: Thu Sep 06, 2007 8:23 am Subject:

Thanks for the info ald_ked! I have had alot of experience with insurance! My son was in and out of hospitals for 12 years. We have had the same experience. One time, he was admitted and discharged. We were back 3 times in that one day-same copay.

But then we have had instances where ald said, we were there at 10 pm, discharged, and back at 2pm the next day- different copay, because it's another day. Ear infections stink!! After my son had tubes put in, it took care of the problem- wish I had done it years ago.!!

Good Luck..Karen Very Happy

Posted: Thu Sep 06, 2007 8:35 am Subject:

I'm afraid everyone's right, as they are different dates of service. I know in homecare, where I work, that patients usually have to start homecare on the day after they are discharged from the hospital and not the day of, as most insurance companies will not pay for a hospital visit and homecare on the same day, as they say it's a duplication of services.

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