• Outpatient Observation

    What does an observation status mean for your hospital stay?

    Thank you for choosing Wellmont Health System for your healthcare needs. We know hospital visits can sometimes be overwhelming and challenging, which is why we strive to deliver the highest-quality care in the shortest time possible.

    As a patient admitted under outpatient observation status, you will probably stay in the hospital for less than 24 hours as we conduct further testing and evaluation.

    We provide high-quality, compassionate care for every patient. Being in outpatient observation absolutely does not affect the quality of services you receive.

    Why am I not an inpatient?

    Hospitals are required to evaluate several criteria for admission, such as severity of illness, length of stay and planned procedures.

    Therefore, you may be considered an outpatient even if you stay in a hospital overnight. The decision to place patients in outpatient observation is not a choice made by your hospital or your doctors, though.

    In fact, Medicare penalizes hospitals for inpatient admissions that federal, for-profit contractors determine should not have occurred. These contractors make their decisions by reviewing your hospital medical record - sometimes a year or more after your hospital visit - even though they have never met or treated you.

    Hospitals that do not comply with this policy may be accused of fraud.

    Communicate with your care team. 

    In the hospital, stay updated on your status, give detailed medical information to your caregivers and discuss your situation with them.

    Ask your physician whether you have been admitted as an inpatient and request an update every day. Your admission status might change day to day, so it is important to receive updates.

    Tell your physician everything. It is important your physicians know everything about your condition and medical history so they can justify inpatient admission. Federally contracted companies review your medical record to determine whether or not your visit qualifies as inpatient or outpatient observation, and lack of documentation can lead to denied payments.

    Discuss your situation with your hospital case manager. Your physician and case manager will do everything they can, in compliance with federal rules, to justify your admission as an inpatient.

    What does your insurance cover?

    Some insurance providers have different copay and deductible levels for inpatient and outpatient observation stays.

    If you have Medicare, that means your outpatient observation stay, as well as any post-hospital rehabilitation or skilled nursing stay, is covered under Medicare Part B, which has a different deductible.

    Check your policy or contact your insurance provider to determine your exact level of coverage. 

    Stay connected to your health.

    Whether you're an inpatient or outpatient, it's important to stay active in your care - even after your hospital stay.

    At your discharge, you will be given an activation code for your online MyWellmont account, which gives you a simple and secure way to:

    • Request an appointment with your Wellmont providers
    • Check medical information for your children or other dependents
    • Review medications and request refills
    • Send and receive messages with your primary care physician 
    • View and pay bills online

    If you have questions about outpatient observation status, or your care plan, please talk to your care team. They'll be happy to help.