Main Menu

Outpatient Observation FAQ

1. What is outpatient observation?

Observation is a billing which permits patients who have problems (which normally do not qualify for a hospital stay) to be allowed to stay in the hospital for a “specified amount of time”.

2. What is the difference in billing?

An Observation stay is billed under outpatient services (under Medicare this would be under Part B) while inpatient admission is billed under inpatient services (under Medicare this would be billed under Part A Private Insurances may vary but most permit only 23 hours in observation.

3. What kind of problems do people have that would make observation appropriate?

Problems that can be treated in 24-48 hours or conditions for which the cause has not yet been determined.

4. What are some examples of these problems?

Some examples are nausea, vomiting, weakness, stomach pain, headache, kidney stones, fever, some breathing problems, and some types of chest pain.

5. What is meant by a “specified amount of time?”

Different insurance payors have different amounts of time that are covered in observation.

  • Medicare—observation services cannot exceed 48 hours. Typically a decision to release or admit is made within 24 hours.
  • Medicaid allows up to 30 hours.

6. What happens at the end of the “specified amount of time”?

Your physician will decide whether to release you from the hospital or to admit you as an inpatient.

7. What if my physician decides my condition requires inpatient care?

Your physician must then write an order to convert your outpatient observation stay to an inpatient admission.

8. What if my physician decides that I do not require an inpatient care?

If your physician decides that your care can be performed outside of the hospital you will be released, possibly with home health care services if necessary.

9. Can I be placed into outpatient observation after undergoing an outpatient surgical procedure?

Only if it is medically necessary. Medicare allows for a 4-6 hour “recovery period”. The intent of outpatient surgery is to have your surgery and be discharged the same day. However, if you experience a postoperative complication then your physician may place you into observation to monitor you further.

10. What type of post-surgical conditions may warrant further evaluation in “outpatient observation”?

  • Inability to urinate
  • Inability to keep solids or liquids down requiring IV feedings.
  • Inability to control pain.
  • Unexpected surgical bleeding
  • Unstable vital signs
  • Inability to safely walk after spinal anesthesia

11. What if I desire to spend the night after my outpatient surgery? Will Medicare cover this?

No, Medicare will only pay if there is a medical condition that warrants postoperative monitoring. If you desire to stay over for patient/family convenience, you will be fully responsible for payment.

12. What about “self administered drugs” and other services not covered by my insurance?

  • According to the billing rules for Medicare and Medicaid these charges will have to be billed to the patient.
  • Medicare and Medicaid will not pay for your pills or tablets and even some injectable drugs that fall under the category of self-administered. Please refer to the online version of the National Medicare Handbook at www.medicare.gov or call 1-800-633-4227 if you need more information.

A complete list of deductibles/services covered by observation/outpatient status is in your Medicare and You handbook.

If you would like to speak to someone regarding your financial responsibility as a result of this hospitalization, please feel free to contact our Patient Account Liaisons at ext.7689.

 
CAREER OPPORTUNITIES

Dr. Charles Moore joins staff

The Lenoir Memorial medical community would like to welcome Dr. Charles Moore to the medical staff. Dr. Moore recently completed a fellowship in minimally invasive/ bariatric surgery at the ECU Brody School of Medicine. Prior to his move to Greenville he was an attending surgeon, trauma, critical care, and general surgeon at the Aria Health System in Philadelphia, PA.  Dr. Moore is married to Lisa a professor at the Brody School of Medicine.  They have two children.  Dr. Moore may be reached at Lenoir Surgical 252-775-5999.

LEARN MORE

HealthLink - Fall 2014

Check out the latest edition of Lenoir HealthLink! Download the pdf.

LEARN MORE

Health Needs Assessment

Lenoir County Health Department and Lenoir Memorial Hospital are conducting a county-wide health assessment. Your opinions about our community are important to us. Please complete the 2014 Community Health Assessment survey located at this link  https;//docs.google.com/forms/d/1aAOrM2yYy9LUs7uhbpQY8H3Ckxdizx6xL7dG02zRjw0/viewform?usp=send_form

 

 

 

LEARN MORE

Farmers Market pre-ordered deliveries at LMH

Join Chelsea Sutton from Natures Touch Farm in LaGrange as she explains the pre-order process and describes products available from local farmers that will make access to fresh, local, and organic options easy for pick up at LMH.  Pre-order online every other week for pick up on alternate Tuesdays outside the Minges Wellness Center.  Pre-ordering online opens July 14.  Information session are on July7 and July 10 at 1 p.m. at the Minges Wellness Center in studio A.

LEARN MORE

T.O.P.S. (Take Off Pounds Sensibly)

Take Off Pounds Sensibly (TOPS) is an effective way to manage weight control. There is a nominal fee to join TOPS.  Patricia Wyrick is the facilitator for Wednesday mornings and may be reached at 252-523-5391.  These meetings are held from 9 am - 10:30 am in the Neuse Room at Lenoir Memorial (enter through the Minges Wellness Center entrance).  Wayne Seymour is the facilitator for Monday nights and may be reached at 252-569-1681.  These meetings are held from 7 pm - 8 pm in the Lenoir Memorial auditorium which is located on the lower level.

LEARN MORE
 

Pink Heals

The Pink Heals Movement drives pink fire trucks and pink police cars across America bringing the "Cares Enough to Wear Pink" and Pink Heals Movement to cities throughout the country.  They provide a program for  community leaders to adopt and help with fund raising to raise money.  There's is a labor of love for the women of this country and they wage war on anything that may harm women or their families.  They will also have a presence at the Minges Wellness Cneter at 12 noon on October 2.

LEARN MORE

Creepy Complications

Join Sandra Midyette, RN, CDE, as she discusses the importance of blood sugar control to prevent both short and long-term diabetes complications.  The many complications of diabetes can be prevented and delayed.  Join us for an informative session that might be able to help you or someone you love!

LEARN MORE

Halloween Candy Calorie Crushers:  Exercise equivalents of Halloween Candy

Do you know how much gym time you'll need to burn off your favorite Halloween treats?  Exercise Specialist Brittney Bradshaw will help you navigate the dangers of Halloween candy and tell you how to little treat can be a trick to get rid of on the exercise floor! Free to the public!

LEARN MORE

Walking for health: Put on those walking shoes!

Do you know how many steps you walk per day?  Do you know how many steps you are supposed to walk per day?  Aiming for 10,000 steps everyday has many beneficial impacts on overall health, ranging from weight loss, to cardiovascular risk reduction, to strengthening your muscles and bones!  Come join Graham as he discusses why 10,000 is more than just a number when it comes to walking for your health!  Attendees will receive a Minges Wellness Center pedometer to help track their steps!

LEARN MORE

Got Gout?

Join Dr. Geeta Katwa, Carolina Regional Arthritis and Rheumatology, PA for a community education presentation on Gout.  If you have Gout, then you know that Gout presents with sudden, severe attacks of pain, redness and tenderness in joints, most often the joint at the base of the big toe. Dr. Katwa will field questions and help you understand the complex arthritis that is Gout.

LEARN MORE