24 Jan What Is Hospital Observation Status VS. A Hospital Stay?

Not All Hospital Stays Are Considered Inpatient Care When a patient is put into the hospital, they're assigned a status. Inpatient status and observation status are the two most common. When you're admitted to the hospital, it's not always easy to determine if you're admitted as an inpatient or admitted under hospital observation status.   The Difference Between Inpatient Status & Observation Status Inpatient status is what we typically think of as someone being admitted to the hospital. Observation status is a type of outpatient status. However, someone in hospital observation status can spend several days and nights inside the hospital, even though they're technically an outpatient. In fact, they might be in the very same type of hospital bed, right next door to an inpatient. Observation used to be a way to keep someone in the hospital for a short time while doctors tried to decide if they were sick enough to need inpatient treatment. Now, observation patients can sometimes be kept in the hospital for days on observation status. It's easy to see how this can be confusing for patients since we don't tend to think of "outpatient" as involving an overnight stay in the hospital.   Why Does Inpatient vs. Observation Matter? Suppose you're sleeping in the same hospital ward and getting the medical treatment you need. Why should you care whether you're on inpatient status or observation status? You should care because the difference could cost you hundreds or thousands of dollars. For people on Medicare, the distinction between inpatient and observation status is crucial in terms of the out-of-pocket costs for that care and the coverage of care in a skilled nursing facility after the hospital stay. This is described in more detail below. Your health insurance company or Medicare won't pay for your hospital stay as an observation patient. It would have spent as an inpatient in the same manner. Instead, they'll pay for your hospital stay using the outpatient services part of your health insurance benefit. Your share of costs for outpatient services like observation status could be larger than your share of inpatient hospitalization expenses. Although complex and confusing, there are rules, or at least guidelines, your doctor and hospital follow when deciding whether to assign you hospital observation status or inpatient status. To understand how the observation guidelines work and why hospitals assign patients to observation status, see why you'll pay more.   Example Mr. Smith comes to the emergency room with chest pain. Unable to tell whether Mr. Smith has a heart attack, the cardiologist, Dr. Jones, puts Mr. Smith into the hospital on observation status. Mr. Smith spends the night in a hospital room attached to a heart monitor. Throughout the night, nurses check on him regularly. He gets oxygen and has blood tests drawn every few hours. Dr. Jones may even have ordered more extensive tests to determine the condition of Mr. Smith's heart. Late the next evening, after two days and one night in the hospital, Dr. Jones has enough information to determine that Mr. Smith didn't have a heart attack. Mr. Smith is sent...