If the beneficiary cannot go home for safety reasons or refuses to go home and observation services are no longer appropriate, can an Advance Beneficiary Notice (ABN) be issued?
The hospital can bill only for medically necessary observation hours. Non-medically necessary hours in observation are not covered by Medicare. Once a patient no longer requires observation level of care and the patient does not require an acute hospital level of care, the patient should be discharged. If the patient cannot be discharged because of safety or other issues, the patient may be admitted and given a preadmission or admission notice of noncoverage. The patient will become liable only after the notice is issued and the patient is admitted.
Related Questions
- If the beneficiary cannot go home for safety reasons or refuses to go home and observation services are no longer appropriate, can an Advance Beneficiary Notice (ABN) be issued?
- What if you give a patient/family a home health advanced beneficiary notice (HHABN) and they do not want to discontinue the services. What is the agency’s responsibility?
- What Home Safety Services Are Offered?
