Inpatient vs. Observation Status Frequently Asked Questions
What is the difference between inpatient and observation status?
Your status as a patient in the hospital is based on the level of care you need. When we choose your status at first, we decide it based on our understanding of your condition. Sometimes, the conditions and care chosen for inpatient versus observation placement seem similar.
Inpatient status is when you are in the hospital and need specific kinds of care. The care you need is usually more complex or longer. When we choose a formal inpatient admission status initially, it is because we have a care plan that routinely requires more than a day.
Observation status, when chosen initially, is when you are placed in a bed anywhere within the hospital, but have an unclear need for longer care or your condition usually responds to less than 48 hours of care. As an observation patient, you may be admitted after the care starts, or you may be discharged home, or you may receive other care. In short, you are being observed to make sure the care is best for you – not too short or too long.
Please know that no matter what your status, your health care team will provide the care that you need.
Is my status based on how many days I stayed in the hospital?
No, your status is based on the level of care you need, not the number of eventual days that you are in the hospital.
Can my status change while I’m in the hospital?
Yes, your status may change if your medical condition gets better or worse, or if you need more or less care.
For example, you may enter the hospital with observation status, and then be switched to inpatient status because you need a higher level of care than originally expected. We will do our best to make sure that you are informed if your status changes while you are still in the hospital. If you have any questions about your status, please ask your admission nurse.
Will I know if my status or my loved one’s status has changed?
Your admission nurse should talk to you about your status. If your health care team
decides that you need observation service, you may receive a letter explaining the difference between inpatient and observation status.
However, in some cases, the status is not determined until after you leave the hospital.
I was told that I was inpatient status by my nurse, but received a bill for outpatient/observation status. Is this an error?
We try to know your status during your stay, but sometimes final decisions about outpatient observation status can be made after you go home and based on your insurer’s guidelines – this means it could change after you leave the hospital. A patient’s status is always assigned based on how the hospital stay ended, not how it started. We would be happy to double check your status and answer any of your questions. Please call 1-844-591-5949 to speak to our Customer Service Department.
How is a patient’s inpatient or observation status assigned?
Your final status will be assigned depending on how your hospital stay ended, not how it started. There is a chance your status may change from when you first came to the
hospital. The status is based on the level of care you need.
How will my status affect my insurance coverage?
Depending on your insurance plan, your coverage may or may not be different for inpatient and observation status. Your insurance plan may have co-payments or deductibles for observation status that are different than if you were an inpatient. If you have questions about your co-payment, deductibles, or any other coverage questions, please call your insurance plan.
View a PDF version of the Patient Status Frequently Asked Questions.