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Medicare Patients Are First Casualty In Emerging Healthcare Revenue Battles   April 27, 2014

Whatever else you may need financially after age 65 ‒ as a patient, you will likely need a special Medicare calculator that includes a timer. Turns out that how patients are technically admitted to a hospital ‒ and how many “midnights” they stay ‒ both play a critical role in what Medicare will cover and what out-of-pocket costs will be. As the revenue battles heat up ‒ the rules governing Medicare coverage and payment are becoming increasingly complex ‒ and litigious.

The first question is how a Medicare patient is admitted. Was it officially as “inpatient” or did the hospital elect to admit the patient under “observation status?” Beyond that ‒ was the stay for 3 consecutive midnight’s ‒ or was it under the terms of the new “two-midnight” rule (RAC audits pending in March, 2015).

Many patients either don’t know.


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