Location: Texas, USA
Basically, my mom had a brain tumor surgery a couple months ago, but the they messed up and caused an infection (cant prove it, but a nurse talked to us and said the specific type of infection was pretty much impossible to happen from something outside the surgery). So she had to go back to the hospital and get a chunk of her skull removed.
Afterwards, they had to give her the antibiotic through an IV. The charge nurse (who was very rude and dismissive the whole time) told her that she needed to go home and do the rest of the IV treatment herself and that it wasn’t hard. My mom was not comfortable with this, and the charge nurse gave her a list of a couple skilled care facilities nearby she could go to instead. After couple days, the insurance approved the skilled care facility and they discharged her there.
Now, my mom got a bill from the hospital for 50k for the last two days that they we were looking for a skilled care facility as ‘not medically necessary’ because a lower level of care could handle her IV. Which we were trying to find for those last two days. I guess they just wanted her to instantly go home and do the IV herself? She was also not warned at all by the staff about this being a risk for going with the skilled nursing route. Is there anything that we can do to fight this, or is she just screwed?
Thanks!
Comments
Whether your mom was comfortable with this or not does not matter. If the 2 nights were not medically necessary, the insurance will not pay for them. You could try an appeal and see where it takes you.
Most hospital bills will have a heavy discount for cash patient, which she was for these 2 nights. Her bill will be lower than $50k
She’s not screwed. It’s likely a coding issue that’ll get sorted out. The hospital is a lot more likely to get that kind of money from insurance than her and they know that.
Is it a bill from the hospital or her EOB from insurance? If it is actually a bill, what does the EOB from insurance say she owes? If the EOB also says her responsibility is $50k, call insurance and ask what the issue is. If there is no EOB or it doesn’t say she owes $50k, then call the hospital and tell them it hasn’t been billed to insurance correctly.