Hospitals / Health Services Over a Weekend

<p>Being in medical billing I’d love to see how they’re entering these charges for the insurance company. And I’d love to see that eob. Do you have one of the main insurance companies? Ie…blue cross, aetna, cigna? Maybe a less known provider would pay, but no way one of the “big dogs” is paying for a weekend stay with no medical necessity. I had major surgery and had to have it day stay. This just doesn’t pass the smell test to me.</p>

<p>@sevmom – I’m not a medical person only, but the OP said it was for a “24 hour observation” - I would have thought that would entail a hospital admission, since presumably that requires a bed. </p>

<p>Admission on Friday, but no discharge until Monday morning apparently.</p>

<p>Yes, I have one of the “big dog” insurance companies. </p>

<p>And as I have said repeatedly on this thread, the college specifically indicated to my H that they have an agreement with the hospital such that either the hospital doesn’t bill (beyond the first medical-necessity piece) or that the college pays them / picks up the rest of the stay. Which blossom has referred to several times, as she’s explained that the college would likely rather pick up a handful of weekend stays over the year than pay the money to staff a health center on the weekends and/or pick up the liability associated with discharging a student over the weekend and then not having an open health center if the student should suddenly take a turn for the worse. And it’s a win-win for the hospital, since they’d rather at least get some money for an otherwise-unoccupied bed. </p>

<p>“I was curious as to if they offered her a choice; (I’m assuming she is 18 or older) Leave AMA and not got the clearance paperwork you need to go back on campus, thus endangering your status as a student; or just wait til Monday and get the proper paperwork.”</p>

<p>No, that’s not the situation. The clearance paperwork that the college desired wasn’t anything that the hospital could provide. For what I presume are liability purposes, the college required an intake interview, conducted by their health service employees, at the student health care service, on campus. And the student health care service is closed on weekends and so was closed at the time she would have otherwise been discharged. If it had happened on, say, a Tuesday, she would have stayed til Wednesday, been discharged, gone back to campus and had her intake interview first thing, then gone on her way. </p>

<p>I must admit it’s a very interesting situation and something I never would have ever in a million years thought of. Both my older two made at least one trip to ER either on referral from the health center or on their own and I would never have thought the college had much to do with the actual hospital stay portion. But I will say, my oldest son’s small college had a health center that was actually run (staffed and run) by one of the local family practices, really a satellite office, walk-in care center which was clear on the web page for the health service. I don’t believe the college even had anyone on direct payroll. Probably not a bad way to go for a small college. </p>

<p>I think the takeaway is that if parents know their kid has a chronic condition of any kind, it’s worthwhile to check out in advance what the school’s health services hours are and what provisions are made for care outside of normal hours. Of course this could happen to any student, but if the student has a chronic condition, it’s that much more likely to come up. </p>

<p>It is of course easier i this regard, when the student w/health conditions goes to college closer to home, so that the parent(s) can pick the child up from the ER, or even accompany him or her. </p>

<p>Still, I hope noone reading this thread decides to limit their child as a result of this story! I believe college choices for kids with chronic conditions should be based on academics, location, size, vibe, affordability, and all the factors everyone else looks at when choosing.</p>

<p>Pizzagirl, I hope your daughter is well and I hope she loves her school. Again I think your perspective and attitude are admirable :)</p>

<p>My son has a chronic health issue and part of what made us pick schools was access to great healthcare and a hospital close by. I think that has to be a factor for some students. </p>

<p>@Pizzagirl have you asked them what would happen should she, or another student, go to the ER on her own? Would they follow the same rules or would she be allowed to return to campus on a Saturday?</p>

<p>My college sophomore had to visit the ER while on a sports team trip last weekend. (He is a diabetic and had a problem with his insulin while on the road.) The coach drove him to the ER, waited with him while he was seen, drove him to the pharmacy to fill the RX and then drove the team back to campus. </p>

<p>No stop at the campus health services. In fact, I’m not even sure campus health services was alerted in any way. S just walked back into his dorm and went about his business. </p>

<p>Like everyone else on this thread, I’m very interested to hear how PizzaGirl’s insurance company greets this story. </p>

<p>But the point is, the school says it will pick up whatever the insurance doesn’t pay – so it doesn’t matter what Pizzagirl’s insurance will pay. It is OK for people to wilfully incur health care costs not covered by insurance-- people do it all the time. In this case, the university has made the choice to essentially contract with the local hospital to extend stays beyond what insurance will pay for, because they would rather do that than keep their own facility staffed over the weekend-- and they don’t want to take the risk that some kid who they determined was sick enough to need emergency care on a Friday night would be dumped on the street by the local hospital on Saturday or Sunday. </p>

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<p>Those are really bad reasons for requiring that one of their adult students remain in a hospital when there is absolutely no valid medical reason for doing so, and then threatening to deny that student access to her dorm room if she exercises her right to leave the hospital over the weekend.</p>

<p>The staff at the hospital should be trusted to make a medical judgement about whether the student/patient is healthy enough to leave or not. What justification is there for any supposed concern about the student/patient being “dumped on the street by the local hospital”? If the student/patient wants to leave against the medical judgment of the hospital staff, then the hospital can require the student/patient to sign an AMA release form. This should release the hospital from any potential liability, as well as the college (to the extent that the college has any liability to begin with for actions taken by the hospital staff). I will say it again: the convenience and shield from liability that the school seeks do not trump the rights of the student/patient to be free to go where she pleases and when she pleases, assuming that she is not in medical jeopardy and does not pose a danger to herself or others.</p>

<p>So I have to admit, I wondered, would the hospital really call the college and say “Hey deactivate Pizzagirl D’s card so she doesn’t have any place to spend the night,” or was that really an empty threat? I’m in the camp that while this may be a great policy for the college, I think it’s not a good idea to park a kid in a place full of sick people if they aren’t sick. Too easy to pick up something at the hospital. I’m sure the insurance company won’t pay, but that’s not a problem as the college has said they’ll pick up the tab.</p>

<p>I still don’t understand the policy and what the college will agree to pay? If there is no medical necessity from Saturday to Monday, what kind of charges / codes can a hospital even legitimately submit to an insurer?</p>

<p>Thats just it. It should all be paid by the college. Insurance, other than perhaps the very first ER treatment, likely has no diagnosis or medically necessary care to pay for.</p>

<p>This is where I still feel confused and dense on this. If there is no medical necessity, what charges can the hospital even bill the college for? What charges can they even come up with? I can’t imagine any ethical hospital would attempt to submit a bogus bill for unnecessary treatment and then pass that cost on to the college if the insurer didn’t pay. Why would a hospital even put themselves in this kind of position with a college. I know I continue to obviously miss something with this as it just seems to be such a strange setup. As others have said, you probably don’t want to be in a hospital any longer than absolutely necessary. My dad died a few years before he probably would have when he picked up infections in the hospital. I would imagine a college would wan to avoid that potential kind of liability as well by effectively forcing a kid to remain in the hospital when they don’t need to be there. </p>

<p>The daughter was admitted, and didn’t just visit the ER. The daughter was free to leave (and stay on a friends’ couch, even in a dorm). The college reserved the right to make sure the daughter’s health was okay for being on campus. The usual mechanism, being cleared by a college MD, was not avaliable until Monday.</p>

<p>In some situations, this relucance to send the student back to campus after merely being stabilized could be life-saving. Most hospitals stabilize and send people back to PCP’s too early. In this case, the policy ensures continuity of monitoring from hospital to college.</p>

<p>This thread goes around in circles. Pizzagirl already sounds grateful that her daughter is okay and somewhat insightful about the possible reasons for the policy, even if it did not fit her daughter.</p>

<p>Our society is very prone to law suits. If you want to blame anything, look to that.</p>

<p>I agree that this is going around in circles. But this sounds like she was medically cleared for dischage after many hours of observation, not a matter of being given a cursory glance in the ER and then being sent away.
Still not clear so hoping a medical person will clarify- isn’t being in observation different than being admitted?</p>

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<p>The hospital staff isn’t qualified to make this determination?</p>

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<p>The “usual mechanism” is apparently a brief intake interview at the school’s health office. The fact that the school can’t be inconvenienced to make this happen outside of normal working hours and instead is willing to subject one of its students to up to two completely unnecessary nights in a hospital and/or loss of access to the student’s dorm room is absolutely ridiculous.</p>