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Hospital Admin Denied Service


MomtoGiuliana
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I think this is "off topic"....

Just wondering if anyone has had an experience of being denied a medical procedure because they didn?t have medical insurance.

Here?s the situation that my family is fuming over: my sister was supposed to have a procedure to remove a huge kidney stone. It was scheduled for 11/2, after a week-long hospitalization last month due to a serious infection b/c of the stone (they put a stent in and scheduled the procedure). On 11/1 the hospital administrator called and said that if she did not return the phone call in 2 hours, he was cancelling her procedure. She didn?t get the message until after the allotted time, so it was cancelled. The reason for the cancellation: he determined that she no longer had medical insurance. This was not true, the insurance co made a mistake somehow b/c she had just switched to COBRA since she was no longer employed as of 10/31.

Is denying service due to lack of insurance a normal, typical hospital policy for something considered "non-life-threatening"?

Any suggestions for action?

She is now re-scheduled with a different doctor and hospital for next week.

My sister and my mom are really upset?not sure what advice to give them except to write letters and complain about the shoddy treatment. BTW my sister is an attorney, so she is aware of any legal issues, I guess.

Thanks for any thoughts/ideas!

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hi katherine!

i am so sorry about what happened. i think the administrator wasn?t right here, they should have checked with the insurance company and MADE SURE to have spoken to your sister before enying her.

i think this also is about how your sister felt after she heard she was denied. i remember being denied several times because of them being on strike and because they told me there was an emergency (which as it turned out later, was NOT the case). when you are prepared to undergo surgery, which is always at least a BIT stressful, you don't want to be denied just before the procedure. and definately not when they don't have reason to deny you. so i am sure your siser has felt very bad about this and the thing is: there is NOTHING she could do.

i am very sorry this happened to your sister katherine, i do hope the procedure next week will go smoothly and that she will recover soon!

take care,

corina ;)

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Katherine,

Wow. That must be beyond frustrating for your sister and your family. It's really crazy that the administrator could cancel her surgery just like that without warning. A 2 hour warning given on an answering machine shouldn't count.

I don't know how the rules and regulations work for things like this. I know there are some hospitals and doctors offices I've been to that have signs saying something to the effect of "We do not refuese treatment to anyone, regardless of ability to pay." If some places put up a sign like that, perhaps there are others who do regularly refuse treatment if they think someone is unable to pay. But you'd think that the administrator would have at least checked to see if your sister was going to (and able to) pay out of pocket, even if she didn't have insurance.

Rescheduling with a different doctor and hospital sounds like a good plan.

Rachel

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Here, a for profit hospital (like there are really any not for profits anymore) has only one obligation. To stablize an unstable patient, then they can boot them. It's sad and depressing and so non ethical, but they can do it.

We have a couple of both here. Although the other two are applying for a for profit status. The for profit will stablize and turf them to one of the other ones. It's pathetic. They should have checked more carefully however and I'd probably check with the insurance and the state regulatory boards in her state on whether he could that or not.....good luck and hope your sister is better. morgan

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I initially had my pacemaker installation cancelled because I was unable to work and due to that had no insurance. As soon as I got the money to get COBRA coverage I called and they were happy to re-scheduled.

Obligation - legal or otherwise.... Hmmm.... Gray area!

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Not sure about your situation..but I am glad the procedure is re-scheduled.

We had two hospitals in the city I grew up in....the FOR PROFIT would send MANY ER runs to another hospital across town! (the not for profit) when they were busy or did not want to accept the pt!!

The not for profit closed, and now waiting ER room times are EIGHT HOURS OR MORE!! It's criminal if you ask me but apparently very legal. I have personally witnessed 8 hour waits before admission with a family member.

:)

But also, the NOT for profit was in a downtown area (poorer pts) and they branch of this hospital in a suburb is growing in LEAPS and bounds.

It's terrible how they redirect to other ER rooms but it happens ALL the time, even when things are CRITICAL.

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Thank you all so much for taking the time to comment and offer support.

I'll just update you...my sister had complications yesterday. The doctor could not remove the stone from her urethra b/c it has become incorporated into tissue. So he put in a new stent and they will try again in the coming week. If they can't on the second try

she will have to have surgery to resection her urethra. They admitted her overnight b/c her potassium was low and she was having tachycardia.

She's supposed to come home from the hospital this afternoon. Poor thing. I hope she can get through this misery soon.

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I'm glad your sister was able to find someone to treat her, but I'm sorry there are complications. I hope that the surgery next week will go well and that the stone will be able to be removed. I've never had a kidney stone, but I've heard that they are very painful. I hope she is comfortable again soon.

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Dang! That is a dreadful complication for sure, the poor thing!

Hope she gets it taken care of SOON and has some pain meds to help keep her comfortable.

Keep us posted.

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Thanks all.

My sister is back in the hospital. She was vomiting and had diarrhea all last night and became weak. My mom took her to her GP this AM and he was concerned about her electrolytes so sent her to the hospital for fluids--probably to be admitted. She is on really high doses of antibiotics and antifungals and this might be the reason for her digestive upset...

My dad also says she's been diagnosed with peripheral neuropathy--she's been having nerve pain in her arms and legs. Anyway, that is what her GP thinks it is.

I suggested they check her orthostatics while she is at the hospital. I have long suspected my sister has POTS (another sister also has POTS). My parents say they aren't going to suggest it b/c they doubt autonomic dysfunction explains these problems--unfortunately I doubt a doctor will think of it either...

My other sister who has POTS and I do not have digestive issues at all, nor nerve pain, but I know POTS can manifest differently in different people.

Hoping they get to the bottom on this soon. This is her third hospitalization since Sept. At least doctors are taking her seriously and not suggesting the psych diagnoses I had to go through!

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YUCK! I had a C. diff infection about seven years ago. I couldn't take the usual antibiotic they give for it (Flagyl) because it hurt my stomach so much. So I had to take vancomycin for MONTHS at a time (at $5 per pill). Every time I quit taking it, it would come back. Eventually, I got rid of it by taking something called cholestyramine, which actually is a cholesterol drug. It seems to bind up the bad bacteria and help the body eliminate it. But it took almost a year to be free from that nasty bug.

I definitely feel for your sister!

Amy

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