IN-PATIENT or OUT-PATIENT??!

Message

#1 Post by **HokieTay** » Thu Jun 11, 2009 3:06 pm

Hi everyone,

Was your surgery treated as in or out patient?! I got quite the shock today when the hospital called to finalize things. Mine is being treated as an outpatient procedure since I will only be there 23 hours. Surgery is 12:30 pm and then I will be released the next day @ 11 am. So since it's out patient I have to pay about $1100 instead of $200!!! I am so annoyed. Basically I am an hour short of saving 900 fn dollars.

#2 Post by PJ » Thu Jun 11, 2009 3:27 pm

I don't understand why your cost depends on In vs. Out, but I had the same thing--23 hours Outpatient. So stupid that they call it that, when you clearly stay in overnight. I guess it's one of those insurance loophole things. :{

#3 Post by **32withbraces** » Thu Jun 11, 2009 4:29 pm

i am far away from surgery but i was told id be in the hospital for 3 days

#4 Post by **HokieTay** » Thu Jun 11, 2009 5:13 pm

PJ wrote:I don't understand why your cost depends on In vs. Out, but I had the same thing--23 hours Outpatient. So stupid that they call it that, when you clearly stay in overnight. I guess it's one of those insurance loophole things. :{

Yep. It's because of evil insurance companies and hr/corporate/people choosing the plans.

My plan has different costs based on in network and out of network and then also in vs. out. I thought the same thing... I am staying overnight, so inpatient, but nooo. They will find anyway not to pay!

This is my plan (thank god my hospital is in network)-
*Hospital inpatient room and board and other inpatient hospital services: Unlimited days $200 per admission copayment
*Hospital/Facility care â€“ outpatient surgery: 15% of the Preferred Provider Allowance

SUCH CRAP! There isn't a way to get it switched to inpatient, right?

#5 Post by PJ » Thu Jun 11, 2009 6:00 pm

Hmm...well I wouldn't wish complications on anyone, but maybe if you have enough nausea to keep you there that extra hour...

#6 Post by **Audra** » Thu Jun 11, 2009 6:40 pm

The more I read on this site, the happier I am that I live in Canada. I'll gladly take a 1 year waiting list than the insurance issues I read about here.

I am going to be in the hospital for probably 2 nights (so I've been told) so in-patient.

Here, if you are classified as out-patient, you leave within hours of your surgery. My ACL reconstruction was outpatient. Surgery was at 8:00 a.m. and I was leaving the hospital around 4pm (from what I remember).

#7 Post by **sarpevictim** » Thu Jun 11, 2009 8:19 pm

What surgery are you having?

My surgery was outpatient. I was in the hospital for a maximum of about 3 hours, including waiting time, waiting for anesthesia to kick in, the surgery, and waiting for me to wake up. I had SARPE done on my upper palate.

I don't get why they're charging you more for outpatient. Usually it's more for inpatient?

#8 Post by **Twinjoy** » Fri Jun 12, 2009 11:33 pm

While it would stink to have to wait until the day of surgery to try and stay longer I would suggest that you milk it for all its worth! Even if you aren't feeling all that bad make it sound horrible (it may very well be anyway!). Make sure that you don't feel well enough to leave at 11....maybe you tell them you need to stay for lunch because you are not sure how well you will be able to eat at home on your own or something. Seriously if the insurance company is going to try and screw with you I would do it right back and make up any excuse to stay a couple extra hours! The hospital will be on your side and want you to stay until you feel comfortable so don't worry about them trying to kick you out at that time.

I hope it works out for you!

#9 Post by **HokieTay** » Sat Jun 13, 2009 8:12 am

I am having BSSO and Le Forte I.

The only thing I am worried about with pushing it is that with inpatient precertification is required or benefits are reduced by $500! I know, ridiculous. I don't know how that works if it TURNS into inpatient after the fact..

The nice thing is the woman at the hospital seemed very understanding and said they work with you. I can just put $200 down and then pay the $900 over the next year or whatever. What's another bill at this point?! Ughhhh.

#10 Post by **Skitters** » Mon Jun 15, 2009 6:58 pm

I also had Lefort I and BSSO. The plan was to have surgery on Friday morning and stay at the hospital to be discharged Sunday morning. Well, when I woke up Saturday morning they told me they were sending me home early and to get ready to go. I was NOT happy about that and felt that I was in no way ready to make the 4 hour ride home, but I made it and everything worked out fine in the end.

I'm also amazed at the prices you are mentioning. My surgery/hospital stay totaled $94,000! And that was for only staying one night!!

Mon Jun 15, 2009 7:01 pm

my surgery was treated as in patient. Originally I was only supposed to be staying 2 day but due to complications beyond our control and the fact that I was very disoriented and dizzy they kept me till sat.

I had a lefort 1 with a mandable advancement done

#12 Post by **HokieTay** » Tue Jun 16, 2009 3:02 pm

Well I work for the US federal government, which (supposedly) offers some of the best insurance to their employees. Since I only owe $1100 I am guessing my whole hospital stay was around $8000. I think that is ridiculously low for a hospital stay, but I am guessing it's because it's an in network preferred provider hospital. It's also a Blue distinction center... I have Blue Cross Blue Shield.

#13 Post by **cyn** » Thu Jun 18, 2009 2:34 pm

Just had a BSSO done on June 5th and it was considered a "day surgery" - so I had the surgery at 8:00am, was awake by 11:00am, and left by 4:00pm that same day. I'm not sure if this is because of our medical system in BC ( there is a MAJOR shortage of hospitol beds here ), or if this is just how my surgeon does things, but luckily, I felt fine when I woke up, and was able to walk right out of the hospitol on my own.

Best of Luck on whichever route you go! (although that must be VERY frustrating for you that that 1 hour makes such a big difference!)

#14 Post by **HokieTay** » Thu Jun 18, 2009 3:48 pm

I got to the hospital @ 1030 am to check in Monday. I wasn't admitted or whatever until about 11:00am. Surgery supposedly started around 1pm and wasn't done until 7ish pm. Then I went to recovery and then onto my room. Once in my room is when the hours toward inpatient started counting. Long story short, I didn't leave until the NEXT DAY at 4 pm, but it is still covered as outpatient. And my dumb insurance company makes you pay more for outpatient. Oh well, we're neither here nor there now.