The medical insurance coverage for a hospitalized patient has met the maximum and any additional charges will not be paid. The only way to extend coverage is if the physician records an additional complication in the patient's health that needs further hospitalization for observation and/or treatment. The physician feels the patient needs additional time in the hospital prior to discharge. Discuss the potential ethical challenges in this situation.
What will be an ideal response?
Some main points to look for in the answer:
the financial implication of the extended stay - who pays - the facility or the patient;
will the physician incur disciplinary action or disfavor from the hospital management if costs fall to the facility;
if the patient is discharged, what are the risks to her health and recovery;
only if there is an actual complication that has occurred should the physician add this to the coding;
are there cheaper alternatives for extended recovery;
what is the family situation to handle the extra care required
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What will be an ideal response?