title: Ensure that services observation patients receive are necessary and timely.
abstract: CMS changed the payment methodology for observation services to a flat rate that covers most major services patients receive during the observation period. Hospitals can no longer bill for individual services such as injections, infusions, MRIs, and other services, but will receive a flat fee for the entire stay, which in some cases may not cover the observation stay. Case managers should monitor observation patients closely and ensure that the services they receive are necessary for the physician to make a decision on whether to admit or discharge the patient. Collect data on avoidable delays in observation that are due to inappropriate tests and procedures and how the cost of the procedures affect the hospital's bottom line.
mesh_terms: D019090:Case Management; D014487:Centers for Medicare and Medicaid Services, U.S.; D006801:Humans; D024382:Professional Role; D011785:Quality Assurance, Health Care; D014481:United States; D057832:Watchful Waiting