Billing > Facility Billing

Overnight Observation: Outpatient or Inpatient Stay

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Michele:
Based on that it looks like your POS should be 22.  Thanks for sharing the info.

Michele

jerrlin:
Who's responsibility is it to notify the patient that his or her status has changed from Hospital admittance,to Observation Status. Insurance does not cover co pays if you are an outpatient. Therefore the patient would be without knowing responsible for many $$ in co pays. Is this not a question of patients rights and ethics ? 

Pay_My_Claims:
Observation can vary....rule of thumb is it is >=23hrs, but you can have observations up to 48 hrs before you have to admit or discharge.

PMRNC:

--- Quote ---Who's responsibility is it to notify the patient that his or her status has changed from Hospital admittance,to Observation Status. Insurance does not cover co pays if you are an outpatient. Therefore the patient would be without knowing responsible for many $$ in co pays. Is this not a question of patients rights and ethics ?
--- End quote ---

It depends on the medical status of the patient, the hospital USUALLY will cert the admission, if not usually plans allow for 48-72 hours after discharge to certify inpatient. My plan benefits say I am ultimately responsible but when I was in hosp last year the hosp certified the stay.

jerrlin:
Does the Dr. or facility have to notify the patient that they are an outpatient and not an inpatient, after being admitted ?? I read in the CMS that a patient was to be notified in writing.

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