sbjim5755

Hi everyone,

I was wondering if any of you know if insurance will pay for an ER visit after my tummy tuck. I had a belt lipectomy done on April 2nd and had to go to the ER yesterday because I had a 103 fever. After test, chest x-ray, cultures, etc it was determined that I was dehydrated and had a mild case of pneumonia. They gave me two heavy duty antibiotics with the IV fluids for my dehydration. Do you think it will be covered. I have Pacific Care HMO in California.

I don't want to call and ask just in case the paperwork would have gone through ...because I know on the ER discharge paperwork my diagnosis was an acute febrile episode, dehydration and Pneumonia. What do you think?? Thanks for your input

__________________
Jim
Post Op Lap Gastric Bypass on 10/27/05
Weight - 371/336/169/170
pre-op/surgery/current/goal
202 Pounds Gone Forever!!!!!!
Plastics Surgery (Belt Lipectomy) - on April 2nd

MiladyB

Jim, I can't swear to it but I would think they would. It should have been sent to your insurance company with the codes for dehydration and Pneumonia...I would think those would be something that your insurance covers.

Hope you are feeling better. If you have an incentive spirometer at home use it often. That's one of those sucky things that gets you to take deep breaths. I know they may seem silly to use but believe me, they are one of the best things you can do for yourself.

__________________
Beth

Little Victories; Grand Rapids, MI
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sbjim5755

Thanks Beth,

Ido haveone and use it every timethere isa commercial on TV...Thanks for the advice.

__________________
Jim
Post Op Lap Gastric Bypass on 10/27/05
Weight - 371/336/169/170
pre-op/surgery/current/goal
202 Pounds Gone Forever!!!!!!
Plastics Surgery (Belt Lipectomy) - on April 2nd

SueRN

I work for an insurance company. Did your insurance actually deny the belt lipectomy or did you just do it all on your own? The reason is when the claim comes in and it's reviewed, it may deny due to a complication of a non-covered or denied service. Some codes for certain diagnosis will trigger a medical necessity review and some don't. It's possible that you may have to cover the ER bill. Hopefully, the ER bill will just sail thru claims and that will be it. But I would prepare myself to get an ER bill just in case. I'm keeping my fingers crossed for you. Hope you are doing better. Sue