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Inpatient or Outpatient?
What Your Hospital Status Means
Any time you visit a hospital for services, the hospital gives you a status that tells your insurance provider what level of care you need. There are two hospital statuses: Outpatient status includes emergency department visits, observation services, X-rays, tests, and some surgeries. You may be an outpatient even if you stay in a hospital bed overnight. Inpatient status begins when a doctor writes an order to admit you to the hospital. This can be planned (like a hip surgery) or unplanned (like an emergency department visit).
Sometimes, you may have to stay in the emergency department or another part of the hospital for observation . Observation is a type of outpatient service your doctor may use to help decide whether to admit you as an inpatient or discharge you. Hospital Status and Insurance Some health insurance providers, including Medicare, pay different amounts for inpatient and outpatient hospital services. This means the amount you pay may change when your status changes. It’s Okay to Ask If you’re not sure whether you’re an inpatient or outpatient, ask your doctor, a social worker, or a patient advocate. And ask every day if your status has changed. Your doctors and nurses will not treat you differently because of your hospital status.
After-Care Services If you need additional medical care after discharge, Medicare may cover temporary home health services or a limited stay in an approved skilled nursing, rehabilitation, or other facility. If you or your loved one needs these services and you have questions about Medicare coverage, call 1-800-MEDICARE (1-800-633-4227) or visit medicare.gov . } For more on after-care options, see p. 24.
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