As a patient at Mary Washington Hospital or at Stafford hospital, you may
receive care under three different options: inpatient, outpatient, or
Inpatients are kept in the hospital for care, testing, and monitoring when
they are too sick to safely go home. These patients need regular nursing
care, complex or regular testing and monitoring, and ongoing physician
care to get better.
Outpatients receive a test or treatment and go home the same day, either
immediately or a few hours after their tests are complete.
More and more hospital patients are hearing about “observation status.”
But what does it mean exactly? And why is it important to know about this option?
Observation status is when your physician needs more time to determine
if you need to be admitted to the hospital, or if you can have further
testing and treatment outside of the hospital. The decision is based on
your medical needs, but may also be a result of the requirements of your
insurance company. Some insurance companies have clinical care guidelines
that determine if your specific medical needs can be met in observation,
inpatient hospitalization, or outpatient.
So, why does it matter which of the three hospital statuses you may fall
under when seeking care? Here are the top three reasons.
1. Medical Need
When a physician or provider admits a patient to the hospital 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 still be groggy
from anesthesia. Or a patient experiencing chest pain may need further
tests before being admitted to an inpatient unit.
There are times when 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
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.
As healthcare consumers, we each have a responsibility, now more than ever,
to be involved in healthcare decisions. Understanding why we are being
treated in the hospital as an inpatient, observation patient, or outpatient
is an important factor in your health. Asking questions, seeking clarification,
and understanding 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.
All Virginia hospitals are required to inform observation patients of their
status. Patients of Mary Washington Healthcare (Mary Washington Hospital
and Stafford Hospital) are provided a letter explaining their status,
offering support for questions or concerns, and reassuring our patients
that their provider and insurance company have selected the best option
for safe, quality care. Our registration personnel 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 our patient accounts department at