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Lactation Information and Discussion

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Subject:
From:
Sue Jacoby <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 5 Sep 2001 12:14:06 -0700
Content-Type:
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I want to add a bit.... If I were a patient and I was
told that I had to leave because my insurance would
not allow additional time, I would discuss the medical
necessity for staying longer with my doctor, and if
he/she agreed that there was medical necessity, I
would sign to pay myself.  AFTER the crisis was over,
I would, assuming my insurance denied the additional
time, APPEAL the denial citing those magic words,
"Medical Necessity."  Insurance companies are trying
to avoid looking like they are usurping the doctor's
judgement... and if you can provide medical
justification, they usually go ahead and pay.  Trouble
is, most people never argue.

Also, I recall hearing one time that there are some
standard protocols for something like the American
Hospital Association or some similar body which state
discharge should not occur until the baby has been
ovserved having at least "two good feedings."  Does
anybody know more about this guideline?
Sue Jacoby, IBCLC
and insurance company employee...


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