Futterman, Sirotkin And Seinfeld, LLP
Futterman, Sirotkin And Seinfeld, LLP

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Fighting a hospital discharge

On Behalf of | Dec 20, 2021 | Firm News |

A hospital stay should end with a discharge based upon sound medical reasons. But other non-medical factors may play a part in the timing of a discharge that you should be prepared to address.

Payers

Your insurance company or public payors such as such as Medicare or Medicaid, Veterans Affairs or Tricare must approve any predicted tests, procedures, and treatments. They rely on diagnostic codes and procedure codes to approve your ailments and their applicable treatment, tests, and procedures.

These descriptions include an average amount of time for an approved hospital stay. This is based on an ideal patient and may not necessarily address individual patients and their problems. Timelines may conflict with your readiness for discharge.

Longer stays

Early discharge may be grounds for a hospital negligence claim for patients who do not meet the code payment timelines. Medical reasons for fighting discharge may include a hospital infection, medication error or age.

Sometimes, hospital will extend stays without notification if there are problems like a drug error or infection. There are also financial reasons to extend stays. Medicare will not pay for care you need at a skilled nursing or rehabilitation facility, for example, unless you were in the hospital for at least three days. A discharge after two days of care can saddle you with months or years of these costs.

Reasons to leave

Hospitals stays can be unhealthy because these facilities treat the sickest of patients and have high risks of infection. Patients also die in hospitals from reasons unrelated to the illness that brought them into the facility.

A longer stay may also cost more. There can be additional co-pays, deductibles, and co-insurance payments for an extended pay.

Appeals

If you appeal, be certain that an extended stay is medically necessary and does not place you at risk of other health problems. After you received a discharge date and your doctor agrees that you should stay longer, appeal the discharge date.

Hospitals have different procedures, but Medicare’s rules govern Medicare patients in all hospitals and its procedures are sometimes used for other patients. There are also financial penalties to hospitals that have too many readmissions of Medicare patients under the Affordable Care Act’s Hospital Readmission and Reduction Program.

Hospitals typically utilize certain appeal procedures. First, read the discharge notice because it should contain information on your rights and the procedures for appealing a discharge. Seek the patient advocate’s assistance.

Speak to the hospital’s quality information officer who must comply with federal guidelines. Also, determine whether the current plan meets Medicare requirements for safe discharge.

Hospital malpractice can cause serious consequences. Attorneys can assist patients and their families seek compensation.

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