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Unread 01-15-2014, 10:40 AM   #1
SBirn
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Medicare: Watch your classification; "Under Observation" may cost you thousands

Folks:
This was in a different thread with one main post (and no source) and that was my error. I added several sources (websites) that carried similar stories because it's important if you are on Medicare or to make note when you are on Medicare or in the hospital for that matter. But decided since I could not pick up the link for the source, I could not include it and had it deleted.

Medicare is changing as many of us knew it would. Fewer doctors are accepting it and that's from our own foresight and experience. Hospitals appear to be receiving less money. As such, they need to get the money in other ways. This makes sense. So, here is something that has been going on for some years to be aware of. I will include the link.

You are ensuring that the words "Under Observation" are not included first verbally (or in writing is actually better) then on the bill.* If you have it on a tablet or paper and signed by someone, you have a better chance of having it removed or ensuring it can be removed. You may be better off being classified as In Patient but even with that, when I was in the hospital, we ensured the In Patient extensions were going to be covered or I would leave. My partner watched for documentation from my insurance company for the extension.

*There's always a caveat. You may need to be in the hospital to be watched for a few hours. My dad accidentally put chemo in his feeding tube rather than the correct tube. Like no other person (he was in VT in the boonies), he rushed to the hospital. He was under observation and released. So, sometimes it's necessary but you really have to think about the logic and sense of it.

When you are admitted, ensure Medicare will cover you. Sounds a little crazy and it's work but it's for your financial protection. I would not have an implant unless I knew in writing insurance was going to cover it. We waited, unsure how long that was going to take. Then it was thrown on us surgery was scheduled in two weeks.

The first article was picked up by Yahoo! in 2010. The source, however, is the old Washington Post not under the leadership of the CEO of Amazon. Therefore, I consider it credible. It's too long to include any part of these articles. Trust me enough that they are important for you.

Medicare '" What is "Under Observation"? - Yahoo Voices - voices.yahoo.com

The next is from AARP from 2012.

Medicare Inpatient vs. Outpatient Under Observation and Hospital Costs - AARP

The last is from Forbes mag. The source is credible and it's from 9/12. Here's a "catch" paragraph from them.

What the Ongoing Battle over Medicare's Observation Stays Means for Seniors - Forbes

How can a patient receive care in a hospital but not be admitted? It happens when the patient is treated under what Medicare calls “observation status.” These stays are usually for 48 hours or less but can be longer. Most troubling, a patient’s status can be changed while she is in the hospital and without her knowledge.
I will wrap this up. If you have a friend who can help you during your stay, THIS CAN BE AN ONGOING question for the hospital staff or billing department (based on the Forbes' ominous paragraph) and get it in writing or have them show the status from the records.

* * * *
I began by saying things will get worse and that source is to just look at the articles and dates and follow what's going on. They will as we all age and our brain cells start going into a final hibernation (and we lose it a bit). Companies will find other ways to nab your dough. This is certainly one and there will be others - what they will be, I do not know. Just be as prepared as you can be (we have binders with information about us) and be careful.

That's enough of a scare for today. There's just so much to know that I cannot post it all. I reiterate. Be careful.


Last edited by Calvin; 01-15-2014 at 02:14 PM. Reason: Edited title per request
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