New law affects outpatients at Virginia hospitals
Outpatients in Virginia hospitals will be notified of their status, verbally and in writing, under a new state law taking effect July 1, 2015. Patients will also be asked to sign a form letter acknowledging that they understand they are outpatients, even though they may spend the night in a hospital bed and receive a meal.
"Outpatient care is covered differently than inpatient care by Medicare, Medicaid and private insurance plans," said Teresa Gonzalvo, vice president of care coordination for Sentara Healthcare. "The state legislature wants outpatients to be aware of their status so there are no surprises when their bills arrive."
There are a number of reasons outpatients could have an extended stay or spend the night. A patient recovering from a late same-day procedure, but too groggy from anesthesia to go home, might spend the night as an outpatient. A patient experiencing chest pain may present to the emergency department and need to be observed on a medical unit in the hospital for continuing symptoms without being admitted. In this case, the patient would be an outpatient even though they stayed overnight and underwent testing. Any patient requiring a short period of monitoring before going home would be considered an outpatient, even if testing, procedures, and an overnight stay were needed.
The letter patients will be asked to sign will advise them that their outpatient status may affect their insurance coverage for medications and other supplies, or coverage for skilled nursing care upon hospital discharge.
"All hospitals in Virginia are now required to notify outpatients of their status," Gonzalvo said. "We hope outpatients and their families will understand that our care team members need to comply with the law by informing outpatients of their status and asking them to sign an acknowledgement that meets state requirements."
Medicare patients with questions about their status can contact the Virginia Quality Improvement Organization at 1-844-455-8708.Patients with private insurance can call their plans’ customer service departments. Patients with questions about the hospital bills they receive can contact their local hospitals’ financial services departments at the numbers displayed on their bills.