Are you “in” or are you “out”? The patient status that is!!
Many times, whether or not someone is “In” or “Out” carries little consequence, unless it refers to hospital status. Being classified as an “inpatient” or “outpatient” affects how much you are charged for hospital services.
We often work with clients who are dealing with medicare appeals or hospital bills related to their admission status.
Inpatient VS Outpatient & Medicare
Why is this so important for you to know?
- Hospital status can also determine if Medicare will cover care you may receive in a skilled nursing facility after your discharge.
- Also, most commercial insurances follow suit with what medicare does, and in turn, that can affect all of us.
- When you are covered by Medicare, your hospital status can determine which part of Medicare covers your hospital admission.
How do you know if you are an Inpatient or Outpatient?
A patient is an inpatient starting when a doctor’s order officially admits you. This continues until the last day before you are discharged from the hospital. An inpatient hospital admission is based on the judgment of your doctor and your need for medically necessary care. You may hear your doctor say, you will need more than a 2-midnight stay.
You are considered an outpatient if you’re getting emergency department services, outpatient surgery, lab tests, X-rays, or any other hospital services. Your physician can admit you under “Observation” status while they consider admitting you or not. Observation is considered outpatient.
Be sure that each day you are in the hospital, you are informed whether or not you are an “inpatient” or an “outpatient”.
As patient advocates, we always inform our clients to ask about their status and to be sure they receive a Medicare Outpatient Observation Notice (MOON) if they are an outpatient. A MOON informs you of your outpatient status. You are required to receive this notice if you are admitted in observation status for greater than 24 hours.
Medicare A covers Inpatient admission and Medicare B covers Outpatient admission. We always ensure our clients are being billed correctly.