Yes You Can Fight a Hospital Discharge

Hospitals can be brutal about discharging patients. Often they will discharge a patient when the insurance company says to discharge them.

I’ve had hospitals call me at 2 AM and tell me I need to come pick up my resident. I ask them if we can wait until a normal hour like six or seven in the morning. They will fight me on it.

Don’t get me wrong. I love to bring my residents home from the hospital as soon as possible.

Many times the resident comes back from the hospital in worse shape than when they entered the hospital.

That doesn’t mean the person shouldn’t receive the treatment they need before they leave.

It can feel intimidating when everyone at the hospital says you need to leave. Many times the patient isn’t feeling very well and their will to fight is greatly diminished.

That’s why it’s so important to have a family member, friend, or some professional who can act as the patient’s advocate.

There are ways to fight a discharge if you don’t think you or your friend/family member is ready. The big thing is to stand strong and don’t let the people at the hospital push you around.

The various reasons that can stop a hospital discharge include:

• You are not healing from a procedure as you’re supposed to

• You became infected with something at the hospital

• There were some complications from any procedure the hospital performed

• You had a complication from a medication

• You took the wrong medication

• You were affected by the anesthesia in a weird way and had complications

• Perhaps you are elderly or frail and it is not safe to discharge you to another facility

• You need to go to a skilled nursing facility. Medicare won’t pay for you to go unless you’ve been in a hospital at least 3 days

• They misdiagnosed you when you arrived and you need more care than originally thought

Hopefully the hospital realizes one of these scenarios is going on. Then they will submit the required paperwork to your insurance provider with no input from you. You’ll just get to stay.

If not, you can appeal to stay. The appeals process may be different for different insurance carriers but they follow the same general format. Here are some steps you can take:

1. Review your admission paperwork. They should have the discharge appeal process in it. If they don’t, ask for a copy.

2. Talk to the Quality Information Officer (QIO). That is the person at the hospital in charge of appeals. They should get back to you with an appeal status in 24 hours or less.

3. Time Your Appeal. Since the QIO will usually take 24 hours or so to get back to you, start your appeal on the day of your discharge. That will at least buy you an extra day to figure things out.

4. Ask about the “Safe Discharge” Policy. Hospitals that release Medicare patients too early can be penalized by the Government if the patients come back to the hospital too quickly.

5. Request a Second Opinion. Ask for another specialist to review your case and make a recommendation.

The United States medical system has a lot of flaws. That’s why it’s so important for you or your family advocate must stand their grand to receive the treatment they need.