You can call 1-800-633-4227 or visit the  Medicare website.

Any drugs that may be administered by the patient are considered self-administered and non-covered by Medicare when the services are provided in an observation, emergency, short stay surgery, or other outpatient area or status. Accordingly, payment for outpatient self-administered drugs is required and expected from the patient. Examples include oral medications, eye ointments, creams, insulin, etc. Medications provided during an inpatient hospital stay are not considered self-administered drugs and are payable by Medicare.

Observation is considered a hospital outpatient service. Observation services require the use of a bed and periodic monitoring to evaluate an outpatient condition or determine the need for possible inpatient admission. Observation services generally do not exceed 24 hours, yet may extend up to 48 hours. Your stay is considered an outpatient observation service until the doctor determines that you should be admitted to the hospital as an in-patient or discharged. All rules regarding self-administered drugs pertain to observation services the same as for other outpatient areas — i.e., your responsibility.

Medicare requires certain medical necessity guidelines to be met prior to the hospital performing outpatient diagnostic tests. Hospitals are required to have patients sign an ABN when a physician-ordered test is not presented with a diagnosis that meets the Medicare medical necessity requirements. At this point, Medicare requires the patient to sign an ABN, whereby the patient accepts financial responsibility for these charges if they still wish to have the test performed. Every effort is made by the hospital to work with your specific physician to ensure that the Medicare medical necessity requirements are met prior to performing the test.

Usually, you may receive a bill if our billing personnel do not have complete or adequate information at the time of registration to bill for your services. In other cases, you may receive a bill if you were not covered at the time of service. Please call us to discuss any concerns at 770-812-9598 or 770-812-9572.