When to call us about overnight hospital stays
If you or anyone in your family is expecting to stay overnight in a hospital, it’s important that you call us before you’re admitted.
Informing us in advance gives our staff time to review your treatment plan and tell you which services will be reimbursed. It also allows us to follow your case and let you know ahead of time if any hospitalization will not be covered.
Although you may wish to know in advance how many days of your hospital stay will be covered, we cannot give a specific number. The length of each patient’s stay depends on what is medically necessary. However, we will follow your case and tell you in advance when hospitalization will no longer be covered.
Planned hospital stays
For planned hospital stays, please call us at (800) 279-4000 at least five days in advance, whenever possible. This prior notification is called hospital admission notification and is a requirement of your plan. If you don’t comply with hospital admission notification requirements, we will reduce your reimbursement by the amount listed on your Benefit Summary.
Special note about childbirth: Remember that you must notify us within 72 hours of your hospitalization for childbirth, unless you and your baby(ies) have been discharged within 72 hours of your admission. These notification requirements apply for other maternity-related emergency admissions as well, such as an admission for pre-term labor or other maternity complications when childbirth does not occur. If you do not notify us within the time required, your reimbursement will be reduced.
Emergencies
For emergencies that require an overnight hospital stay, you, a family member, physician, or hospital employee must call us at (800) 279-4000 within 72 hours after admission or as soon as it is medically feasible, whichever is later. |
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