Transferring Hospitals: What You Need To Know

Patients may want to transfer to another hospital for a variety of reasons, such as dissatisfaction with the quality of care, the hospital lacking the necessary expertise or specialised equipment, or high costs. While patients have the right to transfer to another hospital, the process is not always straightforward and requires careful consideration of various factors. These factors include insurance coverage, availability of beds, and most importantly, ensuring the new hospital can meet their specific medical needs. Initiating a transfer request typically involves seeking assistance from a hospital case manager, social worker, or patient relations professional, who can help facilitate the process and ensure a safe transition to the next level of care.

Patients have the right to transfer, but hospitals don't have to agree to admit them

Patients have the right to request a transfer to another hospital. This may be due to dissatisfaction with the quality of care being delivered, or because the hospital cannot provide the care the patient needs. However, the patient's current hospital will need to determine whether the transfer is medically justified or necessary. This decision is based on scientific evidence, the patient's diagnosis and condition, and whether the other hospital can offer the patient something unique, such as a specialized burn unit or advanced cardiac surgery capabilities. If a transfer is deemed necessary, the current hospital will contact other nearby medical centers to determine whether they can accept the patient.

While patients have the right to request a transfer, the hospital they wish to transfer to does not have to agree to admit them. The accepting hospital will make a decision based on factors such as bed availability and whether they have the capacity and resources to care for the patient. If the accepting hospital refuses the transfer, the current hospital will need to continue searching for another hospital that can provide the required care.

It is important to note that transferring to another hospital can be a complex process, and there is no guarantee that the preferred hospital will be able or willing to accept the patient. Patients and their families should carefully consider their options and seek the advice of medical professionals before initiating a transfer request. Additionally, patients should be aware of the potential financial implications of transferring, including insurance coverage and out-of-pocket expenses.

In some cases, patients may choose to seek a second opinion or a telehealth consultation with a doctor at another hospital before deciding to transfer. This can help ensure that the transfer is medically necessary and in the best interests of the patient's health and recovery. Ultimately, the decision to transfer to another hospital should be made in collaboration with medical professionals and with careful consideration of the patient's specific needs and circumstances.

Transfers are usually due to medical necessity or dissatisfaction with care

Patients may wish to transfer to another hospital due to medical necessity or dissatisfaction with care. In the case of the former, the hospital may lack the necessary resources, expertise, or equipment to treat the patient. For instance, a small hospital may not have a trauma or stroke centre, or the capability to perform certain procedures such as interventional radiology. In such cases, the hospital will typically reach out to other medical centres to arrange a transfer. However, if the patient or their family initiates the transfer request, they should contact their hospital case manager or social worker for assistance.

Dissatisfaction with care can stem from a perceived breakdown in communication or a lack of trust in the treating doctor. Before requesting a transfer, patients are advised to seek a second opinion from another doctor within the same hospital, as it is uncommon for a hospital to have only one specialist in a particular field. If the hospital does not have another doctor in that specialty, patients can arrange a telehealth consultation with a doctor at another hospital.

It is important to note that transferring to another hospital is not always a straightforward process. Patients cannot simply check themselves into another hospital but must be admitted by a professional with admitting privileges. Additionally, there is no guarantee that the preferred hospital will have an available bed or be willing to accept the transfer, especially if it has nothing unique to offer in terms of specialised care. The financial costs of transferring should also be considered, as insurance plans may not cover out-of-network hospitals, and there may be additional expenses such as ambulance fees and mileage costs.

When considering a transfer, patients and their families should first determine the desired hospital and ensure that it can provide the necessary level of care. This involves finding an accepting physician who is willing to take on the patient's case and coordinate with the current attending physician to ensure a smooth transition. While the patient's medical team should facilitate this process, it is not always easy, and there is no central authority to turn to for support. Ultimately, the decision to accept a transfer lies with the receiving hospital, and patients may continue receiving care at their current hospital while the transfer is being sorted out.

Ask for a second opinion to see if a transfer is necessary

If you are considering a transfer to another hospital because you are unhappy with the care you've received, it is recommended that you ask for a second opinion first. This is because it is unlikely that there is only one doctor of a particular type in the hospital, and there is a good chance that another specialist can weigh in on your care plan. Asking for a second opinion is not an affront to the treating doctor but rather a sign that you are invested in your care. Most doctors welcome bringing a colleague into the care discussion and actively support patients asking for a second opinion.

To seek a second opinion, you should first ask your consultant team to go over your diagnosis and explain anything you do not understand. If you are still unhappy with your diagnosis or would like to consider a different course of treatment, discuss this with them. If you would still like a second opinion after speaking with the consultant, you will usually need to go back to your GP and ask them to refer you again. If your GP agrees to refer you to a new consultant, they will be told that this is for a second opinion, and they may request any relevant test results or x-rays. While waiting for your second opinion, you may wish to inform your initial consultant team about this. If you have a serious medical condition requiring urgent treatment, you should discuss this with your clinical team and ask whether any delay in starting treatment could affect your wellbeing.

If the hospital does not have another doctor in that specialty on-site, you can arrange a telehealth consultation with a doctor at another hospital. If you want to be treated by the new consultant, this will need to be arranged with them and their hospital. People who are referred for a second opinion are treated as a new patient referral and are assessed appropriately.

If, after seeking a second opinion, you still wish to transfer to another hospital, you can ask if the procedure you are being offered is commonly performed at the hospital. If the hospital does not deal with a high volume of that procedure, that is an opportunity to ask for a transfer or a consult with a physician who does more of those procedures.

Determine if the new hospital is in your insurer's network

When considering a transfer to another hospital, it is important to determine whether the new facility is in your insurer's network. This is because insurance plans vary in their coverage of out-of-network hospitals, with some providing limited coverage and others providing none at all. Understanding your financial responsibilities before making a transfer decision is crucial.

To determine if the new hospital is in your insurer's network, start by reviewing your insurance plan details. Insurance providers typically maintain a list of in-network hospitals or healthcare providers on their websites or in plan documentation. You can compare this list against the hospital you wish to transfer to. Additionally, you can contact your insurance company directly and inquire about the hospital's network status. They can confirm whether the hospital is in-network and explain the extent of your coverage at that facility.

If the hospital you want to transfer to is not in your insurer's network, it is important to consider the potential costs and implications. Out-of-network hospitals may result in higher out-of-pocket expenses, including ambulance fees, waiting-time charges, and other unexpected costs. These financial considerations can significantly impact your decision-making process.

In some cases, insurance plans may offer partial coverage for out-of-network hospitals, so it is worth reviewing your plan's specific provisions. Additionally, if there are extenuating circumstances or a demonstrated medical need for transferring to an out-of-network hospital, your insurance provider may make exceptions or provide additional support. Discussing your situation with your insurance company can help clarify their policies and your available options.

While financial considerations are important, Russell Graney, founder and CEO of Aidin, emphasizes that the biggest cost to consider is the cost to your health. Ensuring that the accepting facility is equipped to deliver the care you need should be the top priority. This means verifying that the new hospital has the necessary specialists, resources, and capacity to provide safe and effective treatment without negatively impacting your care and recovery.

There are no guarantees the new hospital will have a bed available

Patients can and do transfer from one hospital to another for a variety of reasons. The most common reason is that the hospital they are in lacks the necessary or specialized expertise to provide care. For example, a patient may need a specific procedure, such as interventional radiology, but the hospital doesn't have a radiologist on staff or the proper equipment to perform the procedure. Another reason could be that the patient or their family is dissatisfied with the quality of care being delivered.

While patients have the right to transfer to another hospital, there are no guarantees that the new hospital will have a bed available or be willing to accept the transfer. The accepting hospital will consider various factors, such as whether they have the capacity and resources to care for the patient and if the transfer is medically justified based on the patient's diagnosis and condition. If the new hospital is unable to offer anything unique or additional to the current hospital, they may refuse the transfer request.

In the United States, patients can ask their current hospital to reach out to other medical centers that offer the required service and request a transfer on their behalf. The current hospital will continue providing care while the transfer is being sorted out. However, it's important to consider the potential costs associated with transferring, including ambulance fees and insurance complications, as these can be significant.

To increase the chances of a successful transfer, it's recommended to first identify a specific physician or consultant at the new hospital who is willing to take on the patient's care and ensure that the facility is part of the patient's insurer's network. This process can be challenging, and there is no central authority to facilitate transfers. Seeking a second opinion or a telehealth consultation with a doctor at another hospital can also provide valuable insight before making a transfer decision.

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