David:
This thread really belongs in the '
Insurance' forum but its a little late now to move it so allow me to add my voice to the chorus that advises you to (a) appeal and (b) have your neurosurgeon send a letter to the insurance company that explains his decision to keep you hospitalized four days, which, as we all know, is pretty standard for AN surgery patients.
My insurance company didn't deny my 4th day (actually 4½) but did attempt to deny the cost of the technician that monitored my facial nerve during the surgery because he was from out-of-town (Pittsburgh, PA) and not in my network. My wife talked to the insurance handler for my case and explained that I had no part in choosing this fellow (although I was glad he was there) and that he was very necessary to the surgery (true). She used to be a supervisor in the claims department of a major insurance company (auto and home, not medical) and is very knowledgeable and persuasive. Not only did Blue Cross pay the technician's fee but waived the 20% they normally would not have paid.
Insurance companies can be obstacles but they are staffed by human beings and can usually be persuaded to do the right thing, although it can take patience and determination, which many of us simply don't have. I'm grateful that my wife does because she has saved us a lot of money over the years by virtue of her negotiation skills and 'insiders' understanding of how the insurance company operates, who to talk to and how to approach them. My usual approach in these situations (a recalcitrant insurance company claim representative denying my claim) is to scream at the rep and forcefully push the 'off' button on the phone. To digress: frankly, I miss the old phones that you could actually slam down on the handset cradle with a satisfying crash. Anyway, this approach is momentarily satisfying but ultimately unproductive as the insurance company still doesn't pay the claim and the abused rep puts a note in your file that says '
Displays severe anger issues'. My wife, on the other hand, can stay on hold for as long as it takes and usually deals with reps in a sweetly reasonable tone of voice. One of her favorite lines is:
"Can you please connect me with a supervisor? Thank you". She knows that claim reps don't have much authority and are usually instructed to just say
"No". Supervisors can actually change a decision on the spot and are less likely to argue with logic and facts. My wife's experience in the insurance business has proved invaluable, many times, as she has had numerous hospitalizations and outpatient procedures over the years and Blue Cross hasn't always been eager to pay the bill as presented.
All this is simply meant as background for my earlier contention that a doctor's letter to the insurance company will likely resolve this problem. I suggest you contact him as soon as possible and get him going on this before the hospital starts getting antsy for their money. Let the hospital billing office know that you're disputing the insurance on the 4th day issue so they won't start billing you and eventually record you as 'delinquent' (in paying). FYI: the hospital I was in here on the east coast, in New Haven, charged about $3,500. per day for a semi-private room and all my needs until I was discharged. About what a 5-star hotel in a resort area charges, just for comparison. But the hotel doesn't offer catheter service or inedible food
Good luck with this, David. Let us know how it works out.
Jim 
