One of the main frustrations of Medicare coverage is having to deal with the differences between being admitted to a hospital and merely being under “observation”. If a patient is in the hospital but is placed under observation care then Medicare doesn’t pay for their stay. Medicare will only pay for the stay if the patient is admitted into the hospital. Fortunately, for those whose hospital stay is followed by a nurse home stay will have the option to challenge their hospital stay status.
Previously in order for a patient to have the ability to challenge a cover denial the patient had to be admitted to the hospital. This new ruling allows for patients who were had their status changed to observation from admission to challenge coverage denials.
These new rulings greatly increase the rights and options for Medicare recipients who have had the claims denied by Medicare.
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