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ScottSuff

Overnight stay denied!

5 posts in this topic

I've been approved by my primary insurance for DBS. However, they have denied inpatient status for the second surgery. The first and third surgery is outpatient and there is agreement between Vandy and my primary insurance.They are saying this invention is considered to be an ambulatory procedure and can be performed in an outpatient status! I'm putting up an appeal and I need some help from this wonderful group. I'm just trying to get some data to help my case. How many of you have had the DBS procedure ( drilling holes and lead insertion) in outpatient status? I don't know of a hospital that will entertain doing it in outpatient status. Appreciate your help.

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Yes, do appeal. I've not had DBS, but I've never seen anyone post that the procedure did not require a night in the hospital. Is your neurosurgeon assisting you in your appeal?

 

Dianne

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Your insurance company sounds like a nightmare.  This is brain surgery-unless it's the battery placement in which case the surgeon will open up your chest to insert the battery pack.  You might pose the question to "Ask the Surgeon" on this NPF website.  Dr. Okun or Dr. Foote do DBS surgery and they can answer your question.   Each hospital has an "ombudsman" and that individual, with considerable authority, is supposed to be able to intervene in medical issues that you want to refer to him/her.  I can't imagine them not keeping you overnight if you've had brain surgery-that doesn't sound possible.  

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I had surgery at Vandy two weeks ago to replace my neurotransmitter (battery) and, as before, it was a day surgery.  If I can be of any help, feel free to message me and I'll be glad to share my experiences!

 

Kim

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Update to original post: My surgeon and I sent appeals to my primary insurance and they granted the appeal and has approved Stage II surgery.At Vanderbilt that is lead insertion. That's good news since I proceeded with the schedule and had Stage I today and have bone markers in my head now. Bring on Stage II!

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