Obviously we are going to fight this because standard protocol for PAO patients is a 5-7 day hospital stay (majority of patients are discharged on day 7). Even if I didn't have a complication to extend my stay I would at least expect coverage for what is considered standard and necessary. I was also on an epidural for the first 3 days. It was taken out on day 4. What do they expect me to do-get out of bed with very little sensation from the waist down and crutch my way home with 3 displaced fractures and 3+screws in my pelvis? Yeah, I don't think so!
For those of you preparing for PAO surgery- check with the hospital and your insurance on what will be covered and make sure that the appropriate amount of days are accounted for. I have read a lot of blogs of women who have had problems with their insurance coverage for this surgery! Apparently the people who review the cases are oblivious to the concept of a PAO procedure and the fact that some patients are on an epidural for longer than 3 days.
Insurances can so very frustrating. You would think it would be common sense to have them cover your stay for the recommended days and then if any complications occurred, they would ask for verification and then cover all the days. I mean seriously who wants to be in the hospital for longer than they have to be. But like I say that is all just common sense and insurance companies don't have that. I am having the same issue myself. They aren't covering my labwork that goes along with maternity care because I didn't use the right lab group. Shouldn't it all be covered maternity. You would think but it never can just be easy. But I remember from nursing school, they have a book of what determines a hospital stay and the length. It is crazy. And to sometimes get the insurance to cover, the hospital staff ( those that deal with the ins. companies) have to be real creative on why the extended stay or the number of days were required. But whatever causes the problems it can be so aggravating how they make it so complicated. Hang in there with that and hold your ground with them.
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