Patients aren't admitted to the hospital so insurance may not cover some expenses
Judith Quinn was sure she had been admitted to the hospital. After all, she had stayed two weeks on a hospital ward, attended by hospital nurses, eating hospital food and examined by hospital physicians, after suffering a severe seizure.
But Quinn soon learned she was mistaken. The hospital's staff didn't consider Quinn an inpatient. Instead, they decided she was there for an "observation stay," a little-known category of medical care.
As a result, her Medicare coverage wouldn't pay for the oral medications she took there or for three weeks she spent recovering in a nursing home after being discharged. Only inpatients get these benefits.
Quinn's case and others like it are raising concern in some medical quarters about observation care—a step up from the emergency room but a step down from a formal hospital stay.
The number of patients affected by the classification is growing because Medicare and private insurers want only the sickest people to be treated in costly, resource-intensive medical centers.
Full Article and Source:
Hospitals' use of 'observation stay' is questioned
Judith Quinn was sure she had been admitted to the hospital. After all, she had stayed two weeks on a hospital ward, attended by hospital nurses, eating hospital food and examined by hospital physicians, after suffering a severe seizure.
But Quinn soon learned she was mistaken. The hospital's staff didn't consider Quinn an inpatient. Instead, they decided she was there for an "observation stay," a little-known category of medical care.
As a result, her Medicare coverage wouldn't pay for the oral medications she took there or for three weeks she spent recovering in a nursing home after being discharged. Only inpatients get these benefits.
Quinn's case and others like it are raising concern in some medical quarters about observation care—a step up from the emergency room but a step down from a formal hospital stay.
The number of patients affected by the classification is growing because Medicare and private insurers want only the sickest people to be treated in costly, resource-intensive medical centers.
Full Article and Source:
Hospitals' use of 'observation stay' is questioned
This is a scam waiting to prey on the unknowing and innocent victims who are trying to cope with a sudden illness or accident of a loved one.
ReplyDeleteThank you for this very important information. NASGA is THE place to go for the latest news!
This new scheme of observation stay can affect everyone, young old, on Medicare and those who have employer health care or their own private insurance plan.
ReplyDeleteThis is underhanded, sneaky, unethical and could be criminal activity and a way for the hospitals to end up owning .... your homes!
Thank you for the wealth of information on your blog - Priceless!
Oh help us now!
ReplyDeleteDoes the hospital have any responsibility here? Are they saying they're just protecting themselves (hence everybody else) and they're forced to do this?
ReplyDeleteCan I believe my eyes? Just when you think they can't sink any lower, they do.
ReplyDeleteThank you for exposing this racket.
This is as wrong as rain and I hope many people find out what they're up to now.
ReplyDeleteIt's outrageous and should even be categorized as criminal.
That's not the only problem:
ReplyDeleteWhy should a simple scalp laceration cost $6,500 for a two-three hour emergency visit?