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Checking Out of the Hospital Early Doesn’t Affect Insurance Coverage

By Lisa ZamoskyAugust 9, 2012
From the WebMD Archives

Why take the time to study this issue? Evidently, there’s an urban legend that has persisted: A patient who leaves the hospital against medical advice (referred to as AMA) can expect his or her insurance company to deny hospital bills. This idea has apparently long been kept alive by doctors who counsel their patients to stay in hospital or literally “pay” the consequences. In a survey, 74% of internal medicine residents and 56% of attending physicians questioned reported believing this to be true.Leaving the hospital before your doctor says you’re medically ready to go may not be a smart move for your health. But it’s not likely to cause any additional damage to your wallet, according to a study recently published in the Journal of General Internal Medicine.

One of the study’s researchers wrote a nice post on the popular physicians’ blog, KevinMD.com, about the situation that inspired her to conduct this study, and the challenge she faced in finding the answer to whether or not insurers deny charges in cases where patients leave the hospital AMA.

Debunking the Myth

To find out if there was any truth to this belief, researchers reviewed the data of 46,319 patients admitted to the University of Chicago’s School of Medicine between 2001 and 2010. Out of the more than 46,000 patients, 526 left the hospital AMA. Insurers refused to pay for just 18 of those cases. However, none of those denials were due to the patients leaving the hospital early and against their doctor’s recommendations.

The bottom line: leaving the hospital against your doctor’s wishes will not cause your medical bills to be denied.

Taking Control

This study points out that it’s not only patients who struggle to get a handle on the rules for accessing and paying for medical treatment; doctors sometimes aren’t clear about the details either. For that reason it’s critical to do your own research and not count on your doctor for information about how your insurance benefits work.

Calling your insurer directly, talking with you benefits administrator at work, and/or consulting your summary of benefits before going for care can help to eliminate confusion or mistakes that can lead to unexpected medical bills.

Share Your Story: Have you ever left the hospital against your doctor’s advice? Why did you do it? Were you ever concerned (maybe because someone told you it was the case) that your insurance coverage would be impacted?

Tell your story in the comments section below.

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