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#1 of 12 Old 08-23-2014, 11:15 AM - Thread Starter
 
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OB VS Specialist

We love our OB, and anything he has to say, generally wins. Unfortunately, our lovely insurance butts in and has us doing extra scans per trimester with a specialist at the hospital. (God forbid they take our OB's word). Even though my OB declared placenta previa is no longer an issue for us and that my placenta has shifted enough to take me off of pelvic rest, I'm still being forced by my insurance to have the specialist look at it next month. If I don't, I pretty much lose my medical coverage. Obviously that's something that we can't afford to have happen. Any advice? Should I just take this extra ultrasound and brush off anything the specialist at the hospital says?

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#2 of 12 Old 08-23-2014, 05:01 PM
 
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The only big thing I could see would be if the specialist rec a c/s due to the placenta but your OB thinks vaginal birth is fine. I can't imagine insurance dictating c/s vs vaginal birth. What other concerns do you have.? Who is to know if you're on pelvic rest or not?
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#3 of 12 Old 08-23-2014, 05:05 PM
 
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If there's a concern about previa or low-lying placenta, I can see the insurance insisting on all the scans, and possibly insisting on c/s.

As someone who had placenta previa, my concern would be that ultrasound machines are not all created equal. If the specialist has a better ultrasound machine, and potentially a better ability to read scans, the specialist's opinion about where the placenta is will be more reliable than your OB's. If your OB and the specialist disagree on that, I would go with the specialist's read, and with the specialist's recommendations about whether vaginal delivery is safe.
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#4 of 12 Old 08-23-2014, 05:33 PM
 
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Originally Posted by MeepyCat View Post
If there's a concern about previa or low-lying placenta, I can see the insurance insisting on all the scans, and possibly insisting on c/s.

As someone who had placenta previa, my concern would be that ultrasound machines are not all created equal. If the specialist has a better ultrasound machine, and potentially a better ability to read scans, the specialist's opinion about where the placenta is will be more reliable than your OB's. If your OB and the specialist disagree on that, I would go with the specialist's read, and with the specialist's recommendations about whether vaginal delivery is safe.
That's true. My OB sends me to a place that has 11 year old US machines! I only go to find out gender, so it's not a big deal for me, but if I needed more detailed information (VCI or PP) I would insist on someplace better.
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#5 of 12 Old 08-23-2014, 07:31 PM - Thread Starter
 
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My OB's practice has their own specialist who cleared me this past Tuesday. But the insurance company insists on a second opinion. I'm cleared for a natural birth, C/S only if something happened during the actual labor process. The machines used at my OB's practice and the specialist's practice are both the same type/model/etc. (I observe these things while waiting).

As for the pelvic rest, my OB put me on it first. And when the insurance started the second opinion thing, the hospital specialist told me I needed to be on pelvic rest. At that point, he was a month behind. The hospital specialist communicates poorly, while our OB has been straightforward the entire pregnancy.

I'd have to say my biggest concern is the specialist. Our hospital is trying to act high and mighty because of their recent remodel that has begun to turn them into a Trauma 1 hospital. I feel like he's trying to make a case out of nothing at this point. Trusting him is the major problem I think we are having.

Sarah & DH Alan 
 
Our angel in heaven, DS Connor 10/2/09 to 10/5/09  
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#6 of 12 Old 08-23-2014, 09:11 PM
 
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You could call insurance and ask to see someone else. Or you could just roll with it, while being up front that your insurance requires a second opinion on your case, but you're happy with your OB, and don't plan to transfer care.

If these OBs are at different hospitals, keep in mind that you'd go to the closest appropriate hospital if you were having a bleeding emergency. Trauma 1 doesn't mean a whole lot in terms of resources for distressed neonates. "Renovating to become a Trauma 1 center" means even less.

If the high-risk consults disagree, you may need to fight with insurance then, but I wouldn't get into it yet.
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#7 of 12 Old 08-24-2014, 05:27 AM - Thread Starter
 
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Originally Posted by MeepyCat View Post
You could call insurance and ask to see someone else. Or you could just roll with it, while being up front that your insurance requires a second opinion on your case, but you're happy with your OB, and don't plan to transfer care.

If these OBs are at different hospitals, keep in mind that you'd go to the closest appropriate hospital if you were having a bleeding emergency. Trauma 1 doesn't mean a whole lot in terms of resources for distressed neonates. "Renovating to become a Trauma 1 center" means even less.

If the high-risk consults disagree, you may need to fight with insurance then, but I wouldn't get into it yet.
My OB (and any others in this city now) have no choice but to use the hospital to deliver. During out hospital's rise to trauma 1, they've bought out a lot of private practice doctors, bought entire areas of land, including residential. They closed down our last birthing center, bought out other areas of land not near the hospital for expansion. It's insanity.

I've been in the neonatal twice this pregnancy and labor & delivery once. But my OB or someone from the practice comes in and takes control. I was forced to sign a waiver saying I wanted their specialist nowhere near me last time when I ended up in l&d. I has fallen and they couldn't detect fetal movement. But the moment my doctor came in, there was fetal movement. They scared us into thinking I was going to deliver a dead child.

My reply probably seems angry and distorted. I'm doing this from my phone, prior to my meds. Sorry about that. I just needed to get the thoughts out before they were lost.
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#8 of 12 Old 08-24-2014, 07:40 AM
 
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In my opinion, I'd have to say just do their extra US (I'm dying to have another US...I just love to see the baby!!!). They will probably do the scan and say yep everything is fine. I think allot of times different practices need to have their own records for liability so that they jumped through the proper hoops It's all the business of being born....

For your own sanity, if you trust your OB then go with his recommendations yet do the hospital's checks and balances....and enjoy seeing the baby on the US Then if for some odd reason they find something your OB didn't then deal with that when the time comes. ... at least that's what I'd do.

Good luck!
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#9 of 12 Old 08-24-2014, 09:59 AM
 
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I would call and complain (politely of course, but thoroughly) to the insurance company, personally. I would not want to deal with the unpleasant specialist and be scanned more than I felt was necessary, but Momma2Merrell places a nice spin on it. I hope it works out for you! Best of luck with this!
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#10 of 12 Old 08-25-2014, 07:05 AM
 
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Wow, this is a crazy tangled web you are stuck in here. I don't know if I've ever seen so many chefs fighting to be in one kitchen like this! I think we as "patients" often don't take our full rights to informed consent (due to being intimidated, or just not knowing, or whatever) but this is even more forced- because they are getting you financially. I know that I couldn't risk losing my insurance. But legally I guess they can do things to you and force you into things that even a doctor couldn't, because they can simply argue that withdrawing medical coverage is not denying you health care (technically). Yikes.
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#11 of 12 Old 08-25-2014, 10:19 AM
 
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I'm kinda surprised because usually the insurance companies want to take the cheapest way out, which is NOT a high-risk specialist! You'd think they'd be happy that the OB has no concerns.
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#12 of 12 Old 08-26-2014, 08:30 AM - Thread Starter
 
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I'd like to think that as well, @Usually Curious . And my OB's practice is getting annoyed. I'm going in a couple of weeks to the specialist. When I go, I'll enjoy seeing Maddy on the screen, getting some extra ultrasound photos for her scrapbook, and ready to give this guy the told you so speech.
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Sarah & DH Alan 
 
Our angel in heaven, DS Connor 10/2/09 to 10/5/09  
2 pups, 10 cats  and always rescuing more!  RIP Momma Furby </3
Baby #2, a GIRL!, due Nov 29th, 2014  

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