In any emergency, time is of the essence. At Boulder City Hospital, we’re committed to providing quality emergency care services for our community.
Our ER provides a safe and comfortable environment with short wait times and convenient access. And our Board Certified Emergency Room Physicians and Advanced Cardiac Life Support Certified Nurses have the ability to handle life threatening situations, arising from sudden onset of illness, accident or injury. The Emergency Care Facility is open 24 hours per day, seven days per week and is always ready to serve the community with both technology and excellence in care.
Boulder City Hospital offers a short-term, outpatient, Medicare Part B-covered Observation Care service used to determine if a patient needs to be admitted as an inpatient or can be discharged. Patients are monitored, typically for less than 24-48 hours, in the emergency department or a designated unit for conditions like chest pain, fainting, or dehydration.
While you may stay overnight in a hospital bed and receive treatment nearly identical to an inpatient, your legal status remains “outpatient” until a doctor formally orders your admission.
Key Characteristics
- Purpose: To assess symptoms (like chest pain, fainting, or severe nausea) or complications after surgery that aren’t immediately clear but require more than a standard emergency room visit.
- Duration: Typically intended to last 24 to 48 hours. Medicare rules generally suggest a decision should be made within two midnights.
- Location: Patients under observation can be placed anywhere in the hospital, including the emergency department or a regular hospital room.
Key Aspects of Hospital Observation
- Status: Patients in observation are technically considered outpatients, even if they stay overnight or for multiple days.
- Purpose: To monitor, diagnose, and treat acute, uncertain conditions to determine if inpatient hospital care is medically necessary.
- Costs: Costs are generally covered under Medicare Part B, requiring copayments for each service (labs, drugs, x-rays) rather than a single deductible, which may be more expensive than inpatient care.
- Notification: Hospitals must provide a Medicare Outpatient Observation Notice (MOON) to patients who receive observation services for more than 24 hours.
- Difference from Inpatient: Observation time does not count toward the three-day inpatient stay requirement needed for Medicare to cover a subsequent skilled nursing facility (SNF) visit.
Why It Matters (Billing & Coverage)
Your status as an observation patient instead of an inpatient significantly affects your costs, especially for those on Medicare:
- Medicare Billing: Observation care is billed under Medicare Part B (outpatient), while inpatient care is billed under Medicare Part A.
- Higher Out-of-Pocket Costs: You may face separate co-pays for each individual service (like tests or medications) rather than the single deductible applied to inpatient stays.
- Nursing Facility Impact: Medicare only pays for subsequent care in a skilled nursing facility (SNF) if you have a prior “qualifying” 3-day inpatient stay. Time spent in observation does not count toward those three days.
- Notification: If you are in observation status for more than 24 hours, hospitals are legally required to provide you with a Medicare Outpatient Observation Notice (MOON) to explain your status and its financial implications.
- 24-Hour Full Scope ER
- Board Certified Emergency Room Physicians
- Advanced Cardiac Life Support Certified Nurses
- Rapid Expedited Transfer
- Medical Air Transport
- Fast Track Stabilization
- Bedside Triage
- Primary Nurse
The Emergency Physician’s Bill is “Separate From” the Hospital Bill.
Emergency Physician’s Bill
Professional fees for clinical and diagnostic evaluation, treatment, and/ or supervision of care.
The Emergency Department Physicians are private doctors who provide direct treatment, diagnostic services and/or supervision of care for patients they encounter in the Emergency Department. When you receive a bill from the Emergency Physicians, it will pertain only to these professional services.
If you have a question pertaining to the Emergency Physician’s bill, please contact their business office
Monday through Friday, 9:30am – 4:00pm
1-800-355-2470
Hospital Bill
Charges pertaining to cost of nurses, ancillary and technical personnel, equipment, supplies, treatment area, etc.
If you are sent a bill from the Hospital, it will only pertain to charges incurred for the use of the Emergency Department treatment area, technical and ancillary personnel, supplies, and equipment, and it will include the Emergency Physician’s fee.