Planned Hospitalizations

To obtain the highest level of benefits for an in-patient hospitalization, it's important to follow the requirements stipulated by your policy. Before your next in-patient hospitalization, make sure to verify the following information:

• What hospitals are part of your plan network? Visit Find a Doctor to assist you.
• Is there a limit on how long I can stay in the hospital?
• Who decides when I am to be discharged?
• Will needed followup care, such as nursing home or home health care, be covered by my plan?
• If I have a serious medical problem, will my plan provide someone to oversee care and make sure my needs are met?

Pre-certification

Unless it is a medical emergency, you need to contact WPS at 800-333-5003 to obtain advance approval before you to go to the hospital. Otherwise, the cost of your hospital care may not be covered.

Before you are admitted to the hospital ask yourself:

• Is there an alternate level of medical care that provides the same quality of care as the hospital? Home care and subacute facilities may offer high quality, cost-effective alternatives for some medical conditions.
• Is pre-admission testing available? Necessary lab and many X-ray tests are available on an out-patient basis prior to your admission to the hospital on an in-patient basis.
• Avoid elective admissions on the weekend. Elective surgery and testing is typically available on weekdays only.
• Ask about discharge planning early. Your physician and other hospital staff can answer questions about how long you need to be in the hospital and the care and/or equipment you'll need on discharge.
• Understand how your benefit plan handles getting a second doctor's opinion to determine whether surgery or another treatment is needed. Are second opinions encouraged or required? Who pays?