MSE Pregnancy Club XIV

HypnoNu

Thanks again Nicki - you're currently my personal c-section expert advisor! I have called Standard Life healthcare because i had a look online and their cheif medical officer has been making statements to the newspapers about how they will always cover c-sections if they're medically necessary, well mine is definitely medically necessary because unless i have it i die. that's about as medically necesary as you can get i think! I spoke to the head of the advisors team and she's passed it to her boss so hopefully something will come of it. All i want is to be able to have a private room and a bit more comfort because they've already told me my stay will probably be 4-5 days rahter than the normal 2-3 because of the reasons for my section, apparently my risks for bleeding are much higher. There's also a midwife who's allocated to the 3 private rooms so i'd get a bit more support, when i've been on the wards before i ended up waiting over an hour for someone to change a wet bed and even then she just gave me the sheets and i ended up changing my bedding myself...

HypnoNu

Sami_Bee wrote: »

Maybe if you could get the doc to provide a letter to say that you are having a section because otherwise you and or baby may die they would pay?:rolleyes: deff fight it though! a section due to breech isn't always necessary so them saying they'd pay for that but not this is wrong IMHO

this is my argument exactly, and if their cheif medical officer state they pay when it's medically necessary then they damn well will pay!

Nicki

HypnoNu wrote: »

Thanks again Nicki - you're currently my personal c-section expert advisor! I have called Standard Life healthcare because i had a look online and their cheif medical officer has been making statements to the newspapers about how they will always cover c-sections if they're medically necessary, well mine is definitely medically necessary because unless i have it i die. that's about as medically necesary as you can get i think! I spoke to the head of the advisors team and she's passed it to her boss so hopefully something will come of it. All i want is to be able to have a private room and a bit more comfort because they've already told me my stay will probably be 4-5 days rahter than the normal 2-3 because of the reasons for my section, apparently my risks for bleeding are much higher. There's also a midwife who's allocated to the 3 private rooms so i'd get a bit more support, when i've been on the wards before i ended up waiting over an hour for someone to change a wet bed and even then she just gave me the sheets and i ended up changing my bedding myself...

OK this is stating the bleedingly obvious (so forgive me if you've done it already!) but have you spoken to your consultant's secretary? If he will do a letter for you now stating that you are booked in for the c section, and the reason why it is necessary and the risks if you don't have it, then you can fax it over to them with a written request for pre-authorisation of the expenses. That's going to carry a lot more weight than a patient enquiry, and it will after all have all the info on it that they'll need for when you actually submit the claim form, so it won't be any extra work for the consultant, just doing it before rather than after the event.

Otherwise, have you actually asked the hospital whether you will need to pay for the private room in your circumstances, or will they allocate it to you free based on medical need anyway? And have you checked how much it would cost if you did end up paying for it out of your own pocket?

My own pretty limited experience is that a private room in an NHS facility isn't hugely better than just being in the NHS tbh! A few years ago my DD, then aged 4 fell and fractured her jaw, but the NHS had a waiting list of 3 weeks to x ray and pin it for her (:eek::eek::eek::eek:). We paid £3,000 for it to be done privately in Great Ormond Street (it happened just as my OH changed from one job to another, so fell in a 1 week insurance dry spot :rolleyes:) and she was in a private cublicle on the NHS ward and got exactly the same treatment and standard of facilities as every other child in the NHS bit of the ward.

HypnoNu

The boss just called and now it's going to someone else! I'm trying to remain polite and not get annoyed.....taking DEEP breaths but i seemed to swaying between anger and tears through the whole conversation, fun fun fun!

HypnoNu

Nicki wrote: »

OK this is stating the bleedingly obvious (so forgive me if you've done it already!) but have you spoken to your consultant's secretary? If he will do a letter for you now stating that you are booked in for the c section, and the reason why it is necessary and the risks if you don't have it, then you can fax it over to them with a written request for pre-authorisation of the expenses. That's going to carry a lot more weight than a patient enquiry, and it will after all have all the info on it that they'll need for when you actually submit the claim form, so it won't be any extra work for the consultant, just doing it before rather than after the event.

I haven't spoken to the consultants secretary because i've never had to make a claim through the insurance before so this was all a bit new to me to be honest, i just called the claims number on my documentation to start with as i didn't know what else the procedure would be, but i'll definitely do that, thanks, anything that adds weight to my case can't hurt right!

Otherwise, have you actually asked the hospital whether you will need to pay for the private room in your circumstances, or will they allocate it to you free based on medical need anyway? And have you checked how much it would cost if you did end up paying for it out of your own pocket?

I would need to pay for it and its £175 a night, it's quite a nice facility to be honest and it's a lot better than the wards i've been on and seen so far!

My own pretty limited experience is that a private room in an NHS facility isn't hugely better than just being in the NHS tbh! A few years ago my DD, then aged 4 fell and fractured her jaw, but the NHS had a waiting list of 3 weeks to x ray and pin it for her (:eek::eek::eek::eek:). We paid £3,000 for it to be done privately in Great Ormond Street (it happened just as my OH changed from one job to another, so fell in a 1 week insurance dry spot :rolleyes:) and she was in a private cublicle on the NHS ward and got exactly the same treatment and standard of facilities as every other child in the NHS bit of the ward.

I have been in the side rooms on one of the normal wards on one of the stays in hospital and they're no better than the rest of the ward to be honest, the only bonus is a bit of privacy and your own loo but the private suites are nicer and i'd much prefer to be there.

Thanks again Nicki - i'm floundering a bit with this as it's all so new to me, i've never had need to claim on any insurance before in my life, or ever been in hospital, and i just wish that it was easier! I just don't appreciate having to fight for something that i would think needs to be covered...stupid insurance companies!!

Nicki

HypnoNu wrote: »

The boss just called and now it's going to someone else! I'm trying to remain polite and not get annoyed.....taking DEEP breaths but i seemed to swaying between anger and tears through the whole conversation, fun fun fun!

Speak to the hospital and to the consultant's secretary in the meantime. It will help you feel as though you are doing something and calm you down a bit, and it might also help to push things along a bit further for you as well, in case the next person comes back with an equally unhelpful or equivocal answer!

Glamazon

HypnoNu - do what Nicki said and calm down.

Please don't get het up about it - they are just people on the end of the phone who don't know their a r s e from their elbow. You will get someone sensible soon - just be patient and don't get worked up. It will get sorted out.

Bear_family

Hey,

Got dragged off the computer no sooner had I logged back on yesterday after my long absence! So here goes again.

I reached my 31st week on Monday and bean seems to be moving lots, which is good.

Our nursery is painted and I have the wadrobe, cot and changing station all up. Just need curtains and a light shade.

I've managed to get loads of clothes from freecycle and I've washed most of them.

Haven't yet packed my bag (but I've got it out of the loft) or written by birth plan.

How was the RL tea, Glam?

Bearx

Nicki

Glamazon wrote: »

HypnoNu - do what Nicki said and calm down.

:rotfl::rotfl: There is a certain irony in my saying that to anyone! Hypno you know it was meant in the best way possible

I am confident that you will get this sorted, but it might be more effort to do so than it should be in an ideal world.

I'm off out now to treat myself to a pedicure as I can't reach my feet to do it properly myself, and they are so swollen and horrid at the moment that I feel like some TLC on them! So won't be picking up posts for a while, but will check in later this evening to see how you're getting on.

HypnoNu

I am trying to be calm, and i'm trying not to have a go at them either because i think i'll get further at this stage with a bit of informed negotiaton rather than throwing my toys out of the pram.....although toys are poised to be thrown if needs be....my friends on her was over with her gorgeous little boy at the moment so that'll take my mind of it for a while!

thanks for all the advice guys, it's really appreciated, xx