Inpatient or Outpatient ?
If you are a Medicare Beneficiary, knowing your patient status during a hospital or emergency room visit will impact reimbursement and your out of pocket expenses.
If you have a loved one who has recently been to the ER and stayed overnight in the hospital you need to be aware of the following:
Your hospital status (whether you are considered an inpatient or an outpatient) depends on whether or not your physician has written orders for an inpatient admission. In other words, your doctor has evaluated your physical status and made a determination that you need to be admitted to the hospital. Your head on the hospital pillow or lying in a bed in a hospital room does not mean you have been admitted. Only having a written physician hospital admission orders makes your status an inpatient.
You are an outpatient if you getting emergency services, being watched or observed or having outpatient tests, your status is considered outpatient.
Consider this…You go the emergency room with chest pain and the hospital keeps you for 2 nights for observation – your status is Outpatient and reimbursement is under Part B. Part B covers your physician services and hospital outpatient services such as lab tests. Part B has a deductible and coinsurance. Part A in this situation will not reimbursement or pay for any of the services.
Depending on the amount of services your balance at the hospital can add up. To avoid any financial surprises, it is best to verify your status and if possible keep a log of services rendered.
For more information check the Medicare website, www.medicare.gov/publications