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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

New Weight Loss Program Offers Bariatric Surgery Option

UNC Lenoir Health Care has launched a new Weight Loss Management Program offering medical and surgical weight loss options which are administered by our experienced multidisciplinary weight loss management tea, and offer an individualized approach to weight loss. Medical options include the Optifast program which consists of full meal replacements with a transition to partial meal replacements. Within our surgical program, led by our highly skilled bariatric trained surgeons, we offer the gastric sleeve surgery and gastric bypass, both through a minimally-invasive approach allowing for a shorter recovery period. The program incorporates exercise, health coaching, and support groups into both sides of the program to provide patients with all the tools they need for success. Call 252-522-7168 for more information.

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Wound Care Now Available at UNC Lenoir

Wound Care services are now available on the 5th floor at UNC Lenoir Health Care. The center, managed by a Healogics, a leader in wound care services, recently installed 2 hyperbaric chambers to aid in the wound healing process. Some wounds require specialists to optimize the potential for healing and those services are now available at UNC Lenoir Health Care.  Chronic and non-healing wounds are defined as wounds that have not significantly improved with traditional therapies.  When wounds persist a specialized approach is often called for and the UNC Lenoir Health Care Would Care Center offers those services.  Physician referrals as well as self-referrals are welcome.

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Lung Cancer Screenings available at UNC Lenoir Health Care

Do you have a history of smoking? If so you may qualify for a lung cancer screening.  Qualified candidates have a history of heavy cigarette smoking; smoked now or have quit in the last 15 years; are between 55-77 and show no symptoms of lung cancer. A physician referral is required.  Ask you physician if a low dose computer tomography lung cancer screening is right for you. For more information visit our wellness website at www.lenoirwellness.org

 

 

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HealthLink - Fall 2016

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

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Be Informed About Mental Health Crisis Resources in Lenoir County

Mental Health Crisis:

24/7 Crisis Services for Lenoir County are available by calling Eastpointe Access Center at 1-800-913-6109 or for TTY-888-819-5112.  Customer Service  Specialists will assist you in finding a crisis provider.

Mobile Crisis Teams are available 24 hours a day.  Professional counselors will speak with you and your family during a visit.  They have an average response time of 2 hours.  This service is provided by Easter Seals - UCP 800-913-6109.

The crisis center in Lenoir County is provided by, PORT Human Services, located at 2901 N. Heritage Street in Kinston.  252-233-2383.  Appointments are not needed for crisis assessment and referral services, Monday - Friday 8 a.m. to 5 p.m.

Suicide:

To be connected to a skilled, trained counselor at a crisis center in your area 24/7 call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255)

The 24/7 National Suicide Prevention Lifeline Network for Lenoir County is provided by REAL Crisis Intervention by calling 252-758-4357 for free couseling and extensive referral services.

Call 911 if there is a medical or life threatening emergency.

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UNC Lenoir Health Care Cancer Center Open House

The UNC Lenoir Health Care Cancer Center recently installed a new TrueBeam Linear Accelerator, the most sophisticated technology east of Duke University, and additionally made some facility improvements.  The public is invited to attend an open house to showcase the facilities changes and to celebrate the advanced technology now available for treating cancer in our community.  Refreshments will be served.

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HealthyLife Weigh - November 2017

This weight management program focuses on weight loss goals supported by healthier nutrition practices and increased physical activity.  It is ideal for the individual needing to lose 10-40 pounds, and at a stage of readiness where lifestyle changes can be made.  Nutrition education is delivered in a 4 week program led by registered dietitian and focuses on the necessary formula for permanent weight loss: balancing calorie intake from food and calorie output through physical activity.  We will assist you in making permanent lifestyle changes to help you get to and stay at a healthy body weight.  This is not a diet but a new way of incorporating positive eating and activity habits.  Each series consists of 4 classes and attendance at all 4 classes is necessary for full benefit.

  • Class #1: Get the Ball Rolling - portion distortion, meal plans, tracking
  • Class #2: More or Less - nutrients to increase & decrease
  • Class #3: Smart Choices - grocery shopping, recipe makeovers
  • Class #4: Mind over Matter - emotional eating, slips & staying on track

Participants will receive two months membership in the Minges Wellness Center with an individual exercise plan developed with an exercise specialist.  Required registration for each session may be completed by calling the Minges Wellness Center at 252-522-7014.  Cost $150 due at registration.

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HealthyLife Weigh - October 2017

This weight management program focuses on weight loss goals supported by healthier nutrition practices and increased physical activity.  It is ideal for the individual needing to lose 10-40 pounds, and at a state of readiness where lifestyle changes can be made.  Nutrition education is delivered in a 4 week program led by a registered dietitian and focuses on the necessary formula for permanent weight loss: balancing calorie intake from food and calorie output through physical activity.  We will assist you in making permanent lifestyle changes to help you get to and stay at a healthy body weight.  This is not a diet but a new way of incorporating positive eating and activity habits. Each series consists of 4 classes, and attendance at all 4 classes is necessary for full benefit.

  • Class #1: Get the Ball Rolling - portion distortion, meal plans, tracking
  • Class #2: More or Less - nutrients to increase and decrease
  • Class #3: Smart Choices - grocery shopping, recipe makeovers
  • Class #4: Mind over Matter - emotional eating, slips & staying on track

Participants will receive two months membership in the Minges Wellness Center with an individual exercise paln developed with an exercise specialist.  Required registration for each session may be completed by calling 252-522-7014.  Cost $150 at registration.

LEARN MORE

HealthyLife Weigh - September 2017

This weight management program focuses on weight loss goals supported by healthier nutrition practices and increased physical activity.  It is ideal for the individual needing to lose 1-40 pounds, and at a stage of readiness where lifestyle changes can be made.  Nutrition education is delivered in a 4 week program led by a registered dietitian and focuses on the necessary formula for permanent weight loss: balancing calorie intake from food and calorie output through physical activity.  We will assist you in making permanent lifestyle changes to help you get to and stay at a healthy body weight. This is not a diet but a new way of incorporating positive eating and activity habits.  Each series consists of 4 classes, and attendance at all 4 classes is necessary for full benefit.

  • Class #1: Get the ball rolling - portion distortion, meal plans, tracking
  • Class #2: More or Less - nutrients to increase and decrease
  • Class #3: Smart Choices - grocery shopping, recipe makeovers, eating out
  • Class #4: Mind over Matter - emotional eating, slips and staying on track

Participants will receive two months membership in the Minges Wellness Center with an individual exercise plan developed with an exercise specialist.  Required registration for each session may be completed by calling 252-522-7014.  Cost is $150 at registration.

LEARN MORE

HealthyLife Weigh - August 2017

This weight management program focuses on weight loss goals supported by healthier nutrition practices and increased physical activity.  It is ideal for the individual needing to lose 10-40 pounds, and at a state of readiness where lifestyle changes can be made.  Nutrition education is delivered in a 4 week program led my registered dietitian and focuses on the necessary formula for permanent weight loss:  balancing calories intake from food and calorie output through physical activity.  We will assist you in making permanent lifestyle changes to help you get to and stay at a healthy weight.  This is not a diet but a new way of incorporating positive eating and activity habits. Each series consists of 4 classes and attendance at all 4 classes in necessary for complete benefit.

  • Class #1: Get the ball rolling - portion distortion, meal plans, tracking
  • Class #2: More or Less - nutrients to increase & decrease
  • Class #3: Smart Choices - grocery shopping, recipe makeovers
  • Class #4: Mind over Matter - emotional eating, slips & staying on track

Participants will receive two months membership in the Minges Wellness Center with an individual exercise plan developed with an exercise specialist.  Required registration for each session may be completed by calling the Minges Wellness Center at 252-522-7014.  Cost is $150 at registration.

LEARN MORE