If you haven’t undergone a surgical procedure before, you may be unfamiliar with common medical terms like “inpatient” and “outpatient” care. The difference between these two services is quite simple, but they can both get confusing or complicated when it comes to insurance coverage. Simply put, the difference between inpatient and outpatient surgery can be described as the following:
Inpatient Care: This type of care begins the minute you’re formally admitted to the hospital with a doctor’s order. Many people confuse overnight stays as the defining factor of inpatient care, but there are instances where you can still be considered an outpatient even if you’ve spent a night or two in the hospital. The care received during an inpatient stay is usually preplanned and based on medical necessity. In short, a doctor’s order is required for inpatient care.
Outpatient Care: This kind of care is administered to patients in the emergency department, at an acute care hospital, or ambulatory surgery center. Patients may make use of the facility’s observation services, lab, x-ray imaging equipment, and more. The difference between inpatient surgery and outpatient surgery is the physician’s order for inpatient care. Patients are usually considered outpatients unless the doctor notes otherwise.
As we mentioned previously, many people confuse overnight stays and observation services with inpatient care. Generally speaking, observation services are an outpatient service even if you’re spending a night or two in the emergency department. If your doctor believes you’ll need more than two nights at a hospital for medical care, he or she may order your admission for inpatient care.
Every insurance carrier, hospital stay, and procedure is different, so it’s impossible to say (at this given moment) what will and won’t be covered for your unique situation. Still, there are plenty of things you can do to get a better understanding of what to expect when your bill arrives. Try calling Scottsdale Liberty Hospital to speak to a billing representative about your incoming procedure. The medical professionals may be able to clue you in on the bill’s total.
Or, they may recommend calling a billing representative with your insurance provider. This may be the best approach because your insurance provider may be able to provide you with exact estimates. Nevertheless, it’s important to ask your physician and insurance provider questions if you’re confused about a particular service at Scottsdale Liberty Hospital.
For more information on Scottsdale Liberty Hospital and how we can help you or a loved one, visit our information request page, or contact us at 480-586-2300
The advice and information contained in this article is for educational purposes only and is not intended to replace or counter a physician’s advice or judgment. Please always consult your physician before taking any advice learned here or in any other educational medical material.