Signing an AMA and insurance

[mrsdocmartin]

So, I am Strep-B positive and refusing abx. My midwife (hospital birth) says I will have to sign an AMA. Is there any way that if the baby does end up needing treatment that the insurance company can deny payment?

[mambera]

You should definitely call your insurance company to check. Many insurance providers will refuse to cover an entire hospital stay if the patient signs out AMA. I don't know whether it's different if you are only signing an AMA form for a specific procedure, but in general insurance companies will go for any excuse to avoid paying for something so you should err on the side of caution.

[Amatullah0]

I've always wondered about this. So, what happens if you go to the hospital in labor, and when abx are suggested you refuse, but don't sign anything? They can't legally send you home, and they also can't legally force you to take the abx. Even if they haven't admitted you yet, if you are going to a hospital that EMTALA law is applied at(i.e. they accept medicaid, regardless of if you have medicaid or not) they can't send you home until the baby is delivered.

They want you to sign the form so they can't be held accountable. So its their problem if you don't sign the form, not yours. Am I wrong?

[Kelly1101]

Originally Posted by mrsdocmartin

So, I am Strep-B positive and refusing abx. My midwife (hospital birth) says I will have to sign an AMA. Is there any way that if the baby does end up needing treatment that the insurance company can deny payment?

You'd have to ask your insurance company, but since the antibiotics are a preventative measure, if you refuse the preventative measure and then treatment is needed for what would have been prevented, I'd bet that they wouldn't pay for it.

[mrsdocmartin]

This is all so scary and stressful. Do you think if I call my insurance company, that I am opening up a huge can of worms? This is actually making me want to switch (at 39 weeks!) to a homebirth. I don't want to be pressured into having the abx. Do you think if I just refuse to sign it that the insurance wouldn't be able to deny any claims?

[MegBoz]

Originally Posted by mambera

Many insurance providers will refuse to cover an entire hospital stay if the patient signs out AMA.

I've seen this before on MDC & I can't see how it can be legal. I started a thread & there's some great info:
http://www.mothering.com/discussions...545&highlight=

Refusing ABTs for GBS is such a small deal! it really is! I can't imagine it being a really big deal from the insurance company's perspective. Besides, your choice isn't a crazy one - it's what they do in the UK! They only give ABTs if you have 2 or more risk factors and the positive swab is only one risk factor.
If they didn't break water so often & do so many dang VEs in US hospitals, (Both of which are shown to increase infection rate) I'm certain the infection rate would be much lower than the already low 1 in 200!

Besides, if your baby shows signs of infection, I suspect you would consent to treatment at that point.

What I would probably do is write all over that AMA form. That way if it ever comes up, the insurance company will see that you've made a very well researched decision, and followed standard medical procedure from the UK, as opposed to taken unnecessary risks. I've read advice here before to write on the hospital's blanket consent form (i.e. that you consent to be checked in as a patient, you do NOT consent to episiotomy, etc.)

[womenswisdom]

I've heard this too, but I've never actually heard from anyone that's it's happened to. I think it's an urban legend and a way for HCPs to scare you into treatment. The insurance company gets coded sheets for services. How would they possibly know whether you refused something or not? They don't see your records, nor do I think it would be legal for them to refuse coverage for this reason. How many people on this board refuse vaccines and are able to have their visits covered if a child gets a VPD? I've never ever heard of them actually not paying.

[mrsdocmartin]

Originally Posted by womenswisdom

How many people on this board refuse vaccines and are able to have their visits covered if a child gets a VPD? I've never ever heard of them actually not paying.

Good point! Although, thus far, I've never had to sign anything when refusing procedures like vaccinations. I hope you mamas are right! I will be sure to write all over that form though. Thanks for the advice everyone!

[mwherbs]

I passed along a link in that other discussion- it is basically used as a threat and many providers KNOW it is a threat when they toss it out there to get you to comply with their wishes- Some providers may not know it is a falsehood/when they pass it on to you but their motivation is probably the same to get the result of you accepting the offered treatment