Tuesday, July 22, 2008

Lutheran General and Advocate Digital EEG Billing

My son was born at just over 26 weeks. If your child is in an Advocate-run NICU, watch out for their practice of doing unnecessary EEGs that won't be covered by your insurance. They did four of these while he was still in the hospital without ever finding anything or having his health impacted one way or another. The problem is the digital readings they do as a spike analysis of the EEG findings. That's what our insurance company defines as experimental. They also say that it doesn't cost the hospital any extra time or money to do the digital read.

One of the EEGs was done before we'd even known it was scheduled. After the initial EEG to check and see if was related to apnea, the EEGs were all ordered by a physician who was even on site to see our son and who billed insurance for digital readings he says he knew would not be covered by insurance. In my opinion, this is just a way for Advocate Lutheran General to bill insurance companies and pad the bills of patients who have long-term stays. This hospital's customer service was anything but and they are poor advocates for these most vulnerable patients. I would strongly encourage any preemie parent to avoid Lutheran General and any Advocate facility if at all possible. We have decided to pull our business from all the specialists at Lutheran General. This is a case where parents of children in the NICU should be treated with respect and procedures performed with informed consent. The should not be license to run wild with tests just because a child is in the hospital for 101 days. Parents should be treated as valuable consumers who can shop around and find better care for their children if they need to. We are taking our insurance dollars where we know our son will get good care and good customer service.

When our son was finally out of the hospital and was referred to this pediatric neurologist for followup, he confirmed our suspicion that the digital reading was not medically necessary. But, now he denies that because the hospital's billing department has told him he needs to. We will continue to fight this on principle, not only to decrease our mounting bills but also to help other parents who shouldn't have to wage this battle while fighting for their children's' lives.