Hospitals / Health Services Over a Weekend

<p>If I understood correctly, she was admitted because the school and hospital have a prearrangement to do so, and not return a student to campus until they are cleared by the campus health center staff on a weekday. She was observed, but not treated, during this stay. Maybe she had a medical consult, but no other healthcare/treatment was provided. She was not “free to leave” as she was not discharged by the hospital. She had no way of knowing that the hospital had this pact withthe school and was probably unwilling to leave AMA for risk (a) of being stuck with a large hospital bill and more importantly (b) being seen as noncompliant and not being permitted to return to campus without greater aggravation.</p>

<p>Sevmom: “Admitted for observation” is the usual language.</p>

<p>That’s the last post from me on this! Sounds like daughter is healthy, which is a good thing. I doubt the extra day was traumatic in any long term way.</p>

<p>“The usual mechanism, being cleared by a college MD, was not avaliable until Monday.”</p>

<p>According to followup posts, there was no college MD who cleared her. She had an interview with a nurse.</p>

<p>The fact that a doctor wasn’t involved in the return to campus makes it even more ridiculous. Surely someone from the college health center could be on call on weekends to facilitate these kinds of situations–if it doesn’t have to be an MD, that allows even more possible people to rotate these duties, I would suspect. That would be far cheaper than keeping the health center open, and possibly even cheaper than paying for hospital charges.</p>

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<p>Going back to this, if the college official got a few hundred dollars for taking 15 minutes out of their day, they would probably be happy to do it. Medical work ethic usually entails being paid for every consultation or treatment.</p>

<p>A few hundred dollars for this service would be a LOT less expensive than two nights of hospitalization.</p>

<p>If the health center must screen all students prior to return, then part of their job description should be a rotating weekend “on call” status to see the students if being discharged from the hospital. Yes, the hospital would have to arrange for these folks to have limited staff privileges to see the students in the hospital as they are being outprocessed, but this doesnt seem too difficult, in light of the arrangement already in place. </p>

<p>My point is watch the eob carefully. Mistakes happen all the time and I could easily see this slipping through and the hospital billing department could bill out the entire stay just see what they could collect from insurance. Maybe they have an agreement, but with part of it being billable, and part of it not a mistake could easily be made. If it is declared not medically necessary and denied the PATIENT, not the college, will be responsible for the bill. </p>

<p>Without a signed statement from the college that they will cover these costs, the patient could very well be holding the bag.</p>

<p>If the hospital is in network with the insu company and tries to file claims, if/when denied by the insurance co, they cannot balance bill the family.</p>

<p>The hospital will code the bills in the way most likely to be covered by insurance. Whatever the insurance doesn’t or won’t pay, will be covered by the college – it is true that the bill may first go to to the patient, but Pizzagirl is not an idiot. I’m sure that she will be able to figure out how to send the bill over to the medical director of the college to arrange payment. The college has already made it very clear to her that they will cover the balance – that should mean all costs incurred beyond her own deductible. </p>

<p>If there are charges that the insurance reduces the cost for – then the hospital cannot balance bill. (Example: hospital charges $200 for procedure X; procedure X is allowed but insurance pays only $120.) </p>

<p>However, if there are charges that are disallowed entirely (not covered by insurance, for whatever reason) – then they would become the patient’s responsibility – but in this case the college has said they will pay.</p>

<p>My daughter went through something similar involving thousands of dollars. She participated in a genetic testing program at NYU, for research purposes, and NYU was supposed to pay 100% – but NYU billed her insurance first, her insurance didn’t pay, and NYU picked up the cost down the line. It was a hassle for her because some of the testing labs involved sent it out for collection first – so my daughter was hearing from collection agencies over bills she didn’t know she had – but it all worked out in the end. NYU paid 100%, my daughter paid -0-. </p>

<p>It’s not all that clear that the insurance will refuse payment, however. The decision as to when to discharge someone who is in the hospital for observation is a judgment call – so quite possible that it would be accepted. The type of medical condition that the patient has might be a factor – and that is something that we don’t know (and really is not our business to know). </p>

<p>Sounds prejudiced toward your daughter. How many kids go the ER and the school never knows about it. HIPAA???</p>

<p>The school health services sent the daughter to the ER in the first place. That makes all the difference. If a student walks into the ER on his or her own, the school is not involved and is not liable. So the student would have still been admitted for observation but most likely released a day earlier.</p>

<p>Or two days earlier.</p>