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Be Careful of "Observation" versus "Admitted"
Old 12-03-2015, 05:53 AM   #1
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Be Careful of "Observation" versus "Admitted"

The coding on your hospital visit could cost you 10s of thousands:

Mish's Global Economic Trend Analysis: Obamacare "Observations" and the Elusive Search for Improvements; Seniors Beware!

That increases the need for awareness. Make sure you are being "admitted, not observed". The difference can set you back $20,000 or more.

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Old 12-03-2015, 07:05 AM   #2
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This was around long before the ACA.

Tuesday, September 7, 2010: Patient's hospital status can affect coverage of nursing home costs by Medicare

Part B + Medigap still pay the hospital bill. It's a related SNF stay afterwards that is impacted. "
If patients don’t spend three days under formal inpatient admission in the hospital, the federal program won’t pay for a subsequent nursing-home stay."

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Old 12-03-2015, 08:49 AM   #3
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A year ago I fell and broke my radius big time. The doctor on call decided to operate and use a plate. He wanted me to remain in the hospital for extra day or two. I told him that I wanted to be admitted and place on inpatient status before anything was done. I guess they did what I said but I never knew. The operation went well and I was discharged about noon the next day. Medicare paid.

I did notice a cringe when I insisted on admission but that could have been just because he was busy and wanted to get with it.

Anyone could have a surgery complication even as an outpatient and end up in a nursing home for an extended stay (e.g. stroke). If outpatient/observation status leads to big unexpected bills, we need for everything to be "inpatient".

Remember just because I insisted on inpatient status doesn't mean they actually changed my status to inpatient.
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Old 12-03-2015, 08:59 AM   #4
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My observation from the article is that
1) they spin this as being a problem caused by the ACA when in fact it is a problem caused by the hospitals' prevarication.

To meet the new goals, hospitals readmit patients, but they don't label it "readmission", they label it "observation".
2) They really don't give any solid advice for a patient to avoid the issue other than "be sure you are being admitted"..
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Old 12-03-2015, 09:11 AM   #5
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Dealt with this in January with MIL who went into hospital for 4 or 5 days after Christmas with a fall and crack in leg bone but no need for surgery. Being holidays complicated any decisions on hospital's part but refused to admit her as there was no surgery required and they couldn't get her into rehab. Was released and told to expect a bill for ~$3,000 which we did get; but the hospital distinctly said when asked that nothing would happen if we didn't pay it. Which we didn't. After the first bill, never heard anything from them. Oh well. American healthcare system at its finest.
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