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Medicare outpatient hospital care may not be what you think it is

Written by Diane Archer

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For financial reasons, hospitals around the country are increasingly classifying overnight hospital stays for people with Medicare—even stays that last more than three days—as outpatient visits.  The problem is that unless the hospital treats you as a hospital inpatient, Medicare will not cover your skilled nursing facility care post-hospitalization.  And, the hospital often has the discretion to classify even lengthy stays as Medicare outpatient hospital care.

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  • MEDICARE BENEFICIARIES ARE BEING DENIED ACCESS TO MEDICARE’S SKILLED NURSING FACILITY BENEFIT BECAUSE ACUTE CARE HOSPITALS ARE INCREASINGLY CLASSIFYING THEIR PATIENTS AS “OUTPATIENTS” RECEIVING OBSERVATION SERVICES, RATHER THAN ADMITTING THEM AS INPATIENTS. AS I MENTIONED IN TIMES OF SICKNESS, MEDICARE BENEFICIARIES AND THEIR FAMILIES SHOULD NOT HAVE TO WORRY ABOUT THEIR HOSPITAL BILLING CLASSIFICATION STATUS AND WHETHER OR NOT MEDICARE WILL REIMBURSE THEIR CARE.OUTPATIENT STATUS WAS BECOMING A SUBSTITUTE FOR INPATIENT STATUS. LONG STAY OUTPATIENT STATUS, HAS INCREASED BY 88% AND IS EXCEEDING 72 HOURS. ACCORDING TO MEDICARE STATUS SHOULD BE DONE IN 24 HOURS NO LONGER.

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