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The Care Transitions department is available to help patients understand the complexities of admission status and insurance coverage.
Although insurance coverage varies, there is an increasing trend for all insurance carriers (including Medicare and Medicaid) to pay for hospitalization only during the “acute” phase of an illness or surgical recovery. This means that your full recovery will usually occur in a setting other than in a hospital room. In addition, many insurance companies have implemented the practice of admitting patients to the hospital under “observation” status. This means that, although you’re staying overnight in a hospital bed and having tests and/or surgical procedures done, the treatment is being provided as an outpatient service.
Your hospital status (whether you are an “inpatient” or “observation”) affects how much you will pay for hospital services (i.e., X-rays, drugs and lab tests), and may affect your eligibility for care in a skilled nursing facility (SNF) following your hospital stay.
Clinical Decision Unit
If you’ve been admitted to The Valley Hospital’s Clinical Decision Unit, click here for more information.
Patients should contact their insurance provider to obtain coverage and network provider information. Click here to see a list of insurances accepted by The Valley Hospital.
If you are a Medicare beneficiary, call 1-800-MEDICARE or visit Medicare.gov to obtain covered benefit information.