Hospital stay

[Jenptte 2]

Hello, I recently got approved for Gastric Sleeve, but was denied my two day hospital stay. I have BCBS of Illinois ppo. Has this happened to anyone ? And what was the outcome. My Doctors office is suppose to do the peer to peer with the insurance company this weeks. Being inpatient. Why would they approve my surgery but deny my stay. Uggghhhh! Help!!!!

[Introversion 1,876]

A hospital stay is not always necessary unless you experience major complications. In the area where I live, gastric sleeves are frequently done on an outpatient basis.

I was sleeved at 9:00 in the morning and went home that same night. My surgery was outpatient. Since a two-day hospital stay can cost your insurance company an additional $10,000 per day, there's a reason they want to avoid approving it by any means necessary.

Explore outpatient/same-day surgery options with your doctor.

[Jenptte 2]

Thank you for your response. It was a requirement giving by my surgeon. They appealed it and will do a peer to peer to come to an agreement.

[hvmontoya 27]

That's intense leave the same day no way I would have been able to. I guess it could have been since I had a revision and the band was unknown to doctor so what should have been 45 min turned into 3 hrs. But I wasn't good till the next day

[Lannie 135]

I have BCBS of Illinois. I was approved for the sleeve and one overnight. That is all my doctor required. Additional nights would only be if there were complications.

Would your doctor be OK with a 1 night stay... maybe the insurance would approve that. Good luck.

[Sleeve1stFitNext 924]

Most insurances deny the hospital stays longer than one night because it is usually not necessary. I stayed over night and went home the next morning.

They will only approve it if there maybe a chance of high complications (ex. If you weigh more than 400 - 500lbs or slight heart problems).

However, if complications where to occur after your surgery then they would cover it. However, they will not approve something they do not deem necessary.

I hope this helps.

[Jenptte 2]

Yes it does!! Thank you!

[MSinger 348]

I was initially approved as an outpatient as well, but I had to stay inpatient for 2 nights because I wasn't tolerating liquids. My insurance approved the whole stay. I was told they will not pre-approve the inpatient stay - they wait until after your procedure to see if it's medically necessary.

Edited July 6, 2017 by MSinger

[AmandaWho 158]

Yeah if you're sleeved early enough, here's no NEED to stay. I, however, was the youngest person of the day so I went last and didn't even get to a room til 930pm 🤦🏻‍♀️ so I had to stay.

[Jenptte 2]

3 hours ago, MSinger said:

They just called me and I will be able to have my surgery, but I'll be admitted as outpatient and then once I have my surgery i will be able to stay longer if needed.

Edited July 6, 2017 by Jenptte

[Joann454 1,329]

They just called me and I will be able to have my surgery, but I'll be admitted as outpatient and then once I have my surgery i will be able to stay longer if needed.

I was actually approved for one night but was home within 21 hours of my surgery. I hope your mind is at ease now though. Glad you heard.