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Observation Unit at Mary Washington Hospital

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.

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