Observation Status at Memorial Hospital

What is observation status?

Although you may stay overnight in the hospital, observation status is considered an outpatient service. Observation status allows your admitting health care provider to monitor your condition to determine if you should be admitted to the hospital or allowed to return home after a short stay. During your observation stay, you may require monitoring, diagnostic testing, medications and other treatments before you are able to return home. Therefore, your observation care at Memorial Hospital is considered outpatient hospital care, even if you stay at the hospital one or two nights.

How will this stay be different than an inpatient hospital stay?

In most ways, including quality nursing and medical care, your stay at Memorial Hospital will be identical to a short inpatient stay. If you are a Medicare patient, however, the cost of your home medications may not be covered. To help save you that medication charge during your observation stay, you will be asked to bring in your regular medicines from home in their original, non-expired pill bottles. Once a pharmacist is available to verify the medicines, they will be kept in the unit’s medication room to be given to you by your nurse according to your medication schedule.

What happens at the end of 24 to 48 hours in observation?

Your doctors and nurses will carefully monitor your condition and will determine if you need to be admitted as an inpatient, or are well enough to go home. If discharged home, hospital staff will review your follow-up instructions with you, just as though you were being discharged from any hospital stay. If your condition justifies a longer stay in the hospital, you may be admitted as an inpatient.

What will I be billed for as an “observation” patient? How is this different than inpatient hospital charges?

Your primary health insurance plan dictates how long you may be covered by insurance for observation stay services. Medicare and Medicaid may allow up to 48 hours of observation, while most private insurance plans allow up to 24 hours. The hospital will bill your insurance for each hour you are in an observation status bed in the hospital.

Charges for observation services are calculated and billed differently than inpatient hospital stays, depending on what health care plan covers your stay. Medicare part B is required for Medicare coverage of these outpatient charges. If you are covered by private insurance, contact your insurer for details.

For Medicare patients, prescription and over-the-counter drugs you were taking before this observation stay are not covered during this observation status stay in the hospital. You will be billed for these drugs, unless you have provided your own from home for verification by our pharmacist.

For questions or concerns about hospital charges for observation services, you may contact the Memorial Hospital’s Billing Office at 603-356-5461 ext. 2118.

Who do I ask if I need help understanding my hospital admission status?

If you need help understanding your hospital status, speak to your nurse, doctor or someone from the hospital’s Case Management staff at 603-356-5461 ext 2208 or 2102.

For more detailed information on how Medicare covers hospital services visit: www.medicare.gov/publications to view the “Medicare & You” handbook. You can also call 1-800-MEDICARE (1-800-633-4227).