Financial responsibility of hospitalized patients who left against medical advice: medical urban legend?

Journal of General Internal Medicine
Gabrielle R SchaeferVineet M Arora

Abstract

Physicians may counsel patients who leave against medical advice (AMA) that insurance will not pay for their care. However, it is unclear whether insurers deny payment for hospitalization in these cases. To review whether insurers denied payment for patients discharged AMA and assess physician beliefs and counseling practices when patients leave AMA. Retrospective cohort of medical inpatients from 2001 to 2010; cross-sectional survey of physician beliefs and counseling practices for AMA patients in 2010. Patients who left AMA from 2001 to 2010, internal medicine residents and attendings at a single academic institution, and a convenience sample of residents from 13 Illinois hospitals in June 2010. Percent of AMA patients for which insurance denied payment, percent of physicians who agreed insurance denies payment for patients who leave AMA and who counsel patients leaving AMA they are financially responsible. Of 46,319 patients admitted from 2001 to 2010, 526 (1.1%) patients left AMA. Among insured patients, payment was refused in 4.1% of cases. Reasons for refusal were largely administrative (wrong name, etc.). No cases of payment refusal were because patient left AMA. Nevertheless, most residents (68.6%) and nearly half of at...Continue Reading

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Citations

Jun 4, 2015·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·L BaY Xu
Oct 2, 2014·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Mark A ClarkTara Adyanthaya
Jan 8, 2019·JAMA Internal Medicine·Eric W Rudofker, Emily W Gottenborg
May 4, 2020·Digestive Diseases and Sciences·Olalekan AkanbiPraneeth Kudaravalli
Feb 22, 2021·The American Journal of Medicine·Emily G HolmesDonald L Rosenstein
Jun 28, 2020·Journal of the American Academy of Dermatology·Raghav TripathiJeffrey F Scott
Mar 26, 2021·Journal of General Internal Medicine·Jacob J MayfieldR Jeffrey Kohlwes

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