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Catnapper

Have you ever left a non-psych hospital against medical advice?

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Posted (edited)

Here"s the short version: I had an outpatient procedure with sedation (Propofol like they use for colonoscopies), recovered fine, my ride didn't show and I live alone so was going to take an Uber home. The hospital's new requirement is for your driver to sign that they'll stay with you for the next 24 hours. The evil nurse got in a snit, said I couldn't use Uber, went to talk to someone, came back and said my only other option was to stay overnight. So I said I was leaving and she gave me a big lecture on how insurance wouldn't pay if I left against medical advice. I could feel my mood slipping so I got up and walked out. To be less conspicuous, I went to the next building over (huge hospital) to wait for my Uber. Some minutes later the evil nurse showed up with waiver for me to sign, I refused, which really pissed her off, and shortly thereafter I got in the Uber and left.

Has anyone here left against medical advice, and if you did, what were the consequences? My research when I got home showed that my insurance will more than likely pay. My only real concern is that the hospital has black-listed me and I won't be able to have any other outpatient procedures done there.  

 

Long version: I've been dealing with kidney stones lately, and yesterday I went to the hospital for a previously scheduled outpatient lithotripsy treatment to break up a large stone so the smaller pieces can pass naturally. They give propofol as the anesthetic, and it's very fast acting, and you come out of it very quickly, like 5 or 10 minutes after it's stopped. Due to other medical issues and also recent ECT, I have a lot of experience with propofol, and from back in the day, I have a lot of experience with getting high and can tell how messed up I am, or not. 

The hospital wants you to have someone come with you, stay the whole time, drive you home, and then stay with you for the next 24 hours. I live alone, have been in a depressive episode for most of the time since I moved here for work, so have made a few acquaintences, but no real friends that I would be comfortable asking to take off work to spend hours at the hospital waiting for me. My close friends are all in different states, and I don't have any family left, so I'm basically on my own.

I have previously used a car service that will bring me and stick around, but it costs hundreds of dollars, so this time I took an Uber to the hospital, and planned to take an Uber home, which has been fine in the past, but the hospital has implemented a new policy. They used to put you in a wheelchair, get you to the curb, and you could get in whatever ride you had, like an Uber. Now the nurse goes out and makes the driver sign some paper saying they're going to spend the next 24 hours with you, and they won't discharge you to an Uber driver.

I lied and said my friend had to leave because she had a family emergency and wouldn't arrive for several hours, so I had no other option besides an Uber. This bitch of a nurse said she couldn't allow that, and she went to talk to someone else, and came back and said the only other option for me was to stay overnight. By that time it had been over two hours since the propofol had worn off, so I was completely sober. But I've only been feeling better mood-wise for a couple of weeks and I still feel really fragile, and know that any undue stress could easily push me back into the abyss, or a terrifying mixed episode, and there was no way in hell I was going to spend the night in the hospital.  

I was very upset by this time, although externally I managed to keep my composure, but I could feel things slipping in my mind and had to get out of there. I told the nurse that I was leaving nonetheless, and she gave me a lecture on anesthesia, and said that if I left against medical advice, my insurance wouldn't pay for the procedure, and was just in general very adamant that I shouldn't leave, mean-spirited, and extremely focused on being punitive to me. She went off to talk to someone else, so I got up and walked out. 

It's a huge hospital, so I exited and walked down to the next building to be less conspicuous and called Uber. A few minutes later, the nurse comes stomping up to me and says yet again I'm leaving against medical advice. I said I was leaving anyway. so she said I had to sign a form confirming that I was, and called someone to bring out this form. I looked it over, and refused to sign it, which obviously pissed her off a great deal. I just shrugged my shoulders and looked away. I remained civil, although obviously displeased, and after a few more minutes the Uber showed up and I went to have dinner. (I hadn't eaten in 24 hours by that point, another reason I was upset.) 

At dinner I did a little googling and found that it's an urban myth that insurance won't pay if you leave against medical advice, but one that many medical providers believe is true, and whether they believe the myth or not, they still use it in an effort to get you to stay. If I felt that it was medically necessary to be kept under observation, I would agree with the policy, but this one has obviously been written by lawyers to protect the hospital. It pisses me off that because I'm on my own any medical treatment I receive is going to cost me hundreds of dollars extra because I don't have someone to drive me for free and spend the night. 

Has anyone here left against medical advice, and if you did, what were the consequences? My only real concern is that the hospital has black-listed me and I won't be able to have any other outpatient procedures done there.  

Edited by Catnapper
{Edited to add short version}

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there is nothing in a health insurance contract stating they will not pay for a procedure if you leave early or against medical advice

nothing

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Posted (edited)

My partner left a hospital AMA after a helicopter ride there, and it got paid for.  He also refused to sign the form.  It was really expensive, so if they could have gotten out of paying for it, they probably would have.  He hasn't gotten treated by anyone in that network since then, but the hospital did not mention any blacklisting.  I think it'll probably be ok.  

Edited by Banana Smurf

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Thank you both very much for your reassuring replies. All the hospital systems here are connected by electronic medical records, but hopefully I won't get refused further treatment. I know that they can't refuse emergency treatments, but I'm older so it seems like I end up having lots of scheduled outpatient procedures.

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Just a follow-up with some good news: My insurance company paid for everything, no questions asked. And as far as I can tell, I've not been blacklisted at the hospital. I got my medical records the other day, and there are no notes about leaving AMA. It's an electronic record, so presumably it's complete, and as long and detailed as it is (covers the last year), I am confident that it is complete. What a relief!

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I had an overnight stay in the ER as I had a seizure and another in the ER. Next morning they said they were releasing me they just needed a doc to sign. I waited 2 hours and after being told it would be just a few more mins. I snuck out, got my car a left. That was years ago and there were no repercussions. 

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