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.
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
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
Lenoir Memorial receives $282,898 grant from The Duke Endowment
Lenoir Memorial has received a $282,898 grant from The Duke Endowment to fund the development of a primary stroke center. The grant will be used to develop a comprehensive program that will stabilize the treatment stroke patients including initial acute care. Program components will include prevention, treatment, and post-care follow-up. Constance Hengel, director of Community Programming and Development states, "Death rates from stroke in eastern NC are among the highest in the state and the nation so better stroke outcomes are the goal in this intervention. Rapid recognition of stroke and reduction of time from event to treatment will be a major focus in the project. Time is brain and every minute counts for someone having a stroke. Our hope is to help the community becomes more aware of stroke symptoms and improved recognition and time for getting affected residents to our hospital quickly so we can provide rapid treatment."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
Take Off Pounds Sensibly T.O.P.S.
This support group focuses on how to be successful losing weight and keeping the pounds off. There are two groups that meet at Lenoir Memorial. On Wednesday mornings meetings are held from 9 a.m. to 10:30 a.m. in the Neuse Room located on the lower level at Lenoir Memorial. Pat Wyrick is the facilitator and may be reached at 252-523-5391. On Monday nights meetings are held from 7 p.m. to 8 p.m. in the hospital auditorium on the lower level with Wayne Seymour facilitating. He may be reached at 252-569-1681. Call either facilitor if you have questions.LEARN MORE
Sinus and allergy problems
Ask the expert - Join Dr. Barbara Goheen for expert advice on dealing with your allergies and sinus problems. Free to the public no registration required.
The painful symptoms associated with chronic sinusitis can be overwhelming. If symptoms are difficult to control with medications alone, seeing a specialist may help you to determine the best course of treatment. If you have been diagnosed with chronic sinusitis and are not responding well to antibiotics you may be a candidate for surgery. Your surgeon now has a less invasive option that is clinically proven to be safe and effective. Dr. Goheen is an ear, nose, and throat specialist at Kinston Head and Neck Physicians and surgeons, PALEARN MORE
Beginner’s Shag lessons
You're never too old to dance! Nora Parker will be teaching Beginner's Shag on six Friday nights this fall. The classes begin on October 3, will not meet on October 31, and will finish on November 14. The cost os $50 per couple and you must register with a partner. Advanced registration and payment required call 252-522-7014.LEARN MORE
Exacting Excellent Energies in Kids - tips for parenting the elementary age child
Parents with elementary age children often wonder, why do they do that? Where did the day go? How do I get more structure and schedule to help provide balance in the school/home life? Gain information about techniques that can help provide harmony when demands begin to get hectic. Learn techniques to solicit information from your child and put planning in place to work smarter as a family. Lasting relationships deserve a strong foundation and staying positive is essential. Set the example!LEARN MORE
Challenging Child Behaviors
Children up to 5 years old present new parents with many issues: ages and stages, sibling conflicts, parenting conflict, consistent discipline parameters and safety issues. Gain information on strategies to cope and set early behavior expectations that will assist families with peace and guidance as they start out with young children. Set up your family unit with determination and goals. They are worth it!!LEARN MORE
Get Your Rear in Gear! - Dec 6
This free clinic is for men & women age 40 and up who have never been screened for or had colorectal cancer. The clinic will be led by members of the WellAware team and the Lenoir Memorial Gastro staff. This screening is funded in part by a grant from Get Your Rear in Gear-Kinston and the Lenoir Memorial Foundation. Call 522-7014 to complete required registration. Enter through the Minges Wellness Center to easily access the Neuse Room.LEARN MORE