Update on Texas Hospital Matter

UnitedHealthcare approved the outpatient surgery and the post-surgical overnight observation stay on 12/27/24 within two hours of the request being submitted. There was no need for any further clarification or communication. Our inquiry to the hospital was due to an erroneous order of a separate inpatient stay request. The hospital has acknowledged this error.  Most importantly, the patient received all necessary care, was not responsible for the erroneous bill, which would have resulted in higher costs for the patient, and the surgery and overnight observation stay are covered by the member’s plan with minimal cost to the patient.

Additionally: 

• Our medical director only called the hospital for clarification related to the request for an inpatient stay submitted by the hospital after the surgery and overnight observation stay had already been approved.
• The call for clarification was made to the hospital and our representative asked to speak to the nurse caring for the patient. He did not ask to be transferred to the operating room department, did not ask to speak with the physician while she was in surgery and never asked the doctor to leave surgery.