Anyone have insurance stop paying while child in the NICU?

jlh123

Our doctor told us today that the utilization review nurse came to her and said that insurance wants our daughter discharged and doesn't understand why she's still there.  Ummmm she desats every day that's why.  They repeated the sleep study last night and the good news is that she's growing out of the central apnea and it's mostly only feedings.  So they have an ENT specialist coming to look at her and will have the video scope test done Monday.  The doctor told us at least 10 more days because they have to figure this out and she'll have to have 5 days at least without any episodes while feeding (sleep episodes as well but those are likely gone it looks like).  They started the reflux medicatin today.  It's so strange because at the last sleep study it wasn't showing reflux, but this one did.  The dr.l said that the insurance just wanted her discharged on all kinds of meds and monitors.  I'm really afraid they won't pay for much more which is fine, my children's lives are pricelss and whatever it takes, we'll do it.  I just can't believe how they are threatening to stop paying. 

I thought about calling but the utilization review person is currently handling it and hasn't mentioned it to me yet. 

hoping4more

Wow that sucks, and they are adding even more stress to an already stressed NICU mom. I hope things turn out okay for you and dont let them push you into doing something thats not best for your DD

TriciaJoy

we didn't, but I wouldn't worry too much about it. Even if they try to stop, there are a dozen appeals you can go through. It just makes a lot of work for the doctors and staff at the hospital- but they're used to it, and it's their job.

 

I had insurance companies. I know they're a necessary evil, but man they piss me off.

southphilly

ugh.  I dread this.  I hate having conversations with the ins rep (she's sometimes there when I am).  she seems to think coming home on 02, monitors, a g-tube is totally reasonable.   good luck.  pp is right-you can appeal their decision.