Hospital Classified as NICU Level III but billed NICU Level IV

[NewMomYay]

I hope someone can please help me. I had my daughter at Hillcrest in Tulsa OK. From all my research and reading messages I have found that Hillcrest is a Level III NICU. However when they billed my Insurance they billed for Level IV NICU. Is this right? How can a hospital that is classified as a Level III bill for Level IV? Is that wrong or is it ok? Thanks

[babyNP., APRN]

There is no such thing as a "Level IV" NICU; this is a common misconception.

Instead, there are what are called, Level IIIa, IIIb, and IIIc.

To be fair to the hospital, the difference between a level IIIa and a level IIIa are enormous. A level IIIa may take care of vented patients (babies with breathing tubes down their throats), but a level IIIC does pediatric surgery and ecmo and it's easy to assume that one hospital does the same thing as others if they have the "level III" designation.

Does your daughter's hospital do surgery on babies? I'd suggest getting in contact with the social worker if you have financial issues; there's often help to be had if you need it.

Congratulations on your little one!

[BranRN]

Exactly!

In my level III we classifiy each patient by acuity. The acuity options are I, II, III, or IV. The acuity determines how a patient is billed, among other things. Just thinking that maybe your little one was an acuity IV patient at some point.

[Jolie, BSN]

Good for you for taking the time to review your hospital bill and question it!

If you call the billing office, someone should be willing to review it and explain it. You may be surprised at the errors you catch and the money you save yourself and your insurance company.