Observation medicine is one of the newest and most rapidly growing subspecialties
in emergency medicine. To meet the needs of our growing community, we
have created a specialized observation unit for patients who meet criteria
for this specialized care.
Observation status offers an option between traditional inpatient admission
and discharge from the Emergency Department. Patients will receive basic
treatment and tests to determine if they can be discharged with instructions
to follow up with another provider like a primary care physician or a
specialist, or if their condition requires inpatient care. The decision
to place a patient in observation status is based on medical needs, but
it may also be due to requirements of a patient’s insurance company.
Some insurance companies have clinical care guidelines that determine
if specific medical needs can be met in observation, inpatient hospitalization,
or outpatient care.
All Virginia hospitals are required to inform observation patients of their
status. Patients of Mary Washington Hospital are provided a letter explaining
their status, offering support for questions or concerns, and reassuring
our patients that their provider(s) and insurance company have selected
the best option for safe, quality care. Our registration team will speak
with each observation status patient or guardian to clarify what observation
status means.
If you have questions or need help understanding your bill:
Call your insurance company
Call the MWHC patient accounts department at
540.741.1041
How do these three treatment statuses - observation, inpatient, or outpatient
- affect patients?
1. Medical Need
When a physician or provider places a patient under
observation status, the patient needs more care before it is safe to return home. In some
cases, a patient may have had an outpatient procedure and is still groggy
from anesthesia. Or a patient experiencing chest pain may need further
tests before being admitted to the hospital as an inpatient. on occasion,
the time it takes to conduct the tests and interpret the test results
requires patients to stay overnight. Patients can still be under
observation status and stay overnight in the hospital.
2. Financial Responsibility
Observation status is considered an outpatient service. Outpatient care is covered differently
than inpatient care by Medicare, Medicaid, and private insurance plans.
Each plan handles co-pays for inpatient and outpatient care differently.
As a patient, you should read your individual insurance plans carefully
so you know what your personal share of your hospital bill will be. Coverage
for care from a skilled nursing facility/home or other community-based
organization after discharge may also be affected.
3. Personal Involvement
Understanding why you are being treated as an inpatient, observation patient,
or outpatient is an important factor in your health. Asking questions
and seeking clarification about your tests and further treatment are all
important ways to be involved in your care. You will be healthier if you
leave the hospital with a clear understanding of how you can stay healthy
or seek additional help for your illness.
