Hospitals must give BCN Advantage members receiving outpatient observation services the Medicare Outpatient Observation Notice
The Centers for Medicare & Medicaid Services requires hospitals to give a Medicare Outpatient Observation Notice to Medicare beneficiaries receiving outpatient observation services for more than 24 hours.
BCN AdvantageSM encourages providers to start giving these notices immediately. A copy of the Medicare Outpatient Observation Notice customized for BCN Advantage members and the instructions for using it are available on the web. These documents are available on the Care Management Forms page in the BCN section of this website, under the BCN Advantage heading.
The Medicare Outpatient Observation Notice is a standard notice that lets the member know that:
- He or she is an outpatient receiving observation services, not an inpatient of the hospital
- The reasons he or she is receiving observation services
- How the observation services affect his or her cost-sharing obligations and post-hospitalization eligibility for coverage of skilled nursing facility services
The notice must be delivered no later than 36 hours after observation services begin, or sooner if the member is transferred, discharged or admitted.
The BCN Advantage chapter of the BCN Provider Manual will be updated with this information. The revised chapter will be available at the end of January on the Provider Manual Chapters page in the BCN section of this website.
Additional information about this requirement is available on the Beneficiary Notices Initiative page of the CMS website.
Posted: January 2017
Line of business: Blue Care Network