1. Facility & Hospital Patient Types

2. Hospital Inpatient
Short Term vs. Long Term Acute Care
Ambulatory/Outpatient
Day Surgery
Emergency
Clinic
Diagnostics
Outpatient Observation
Physician Office
Skilled Nursing Facility
Home Health

3. PATIENT TYPES Determined by characteristics such as
Services & level of care provided to the patient
Licensure of facility
Physician must order services and levels of care
Affects the content and organization of health records
Affects coding and billing of services
SLIDE 2
Provided in in day or in less than 24 hours… receive services in a relatively short amount of time. Distinguishes from IP in which pt is expected to stay over night. In true ambulatory settings the interaction between the pt and providers is referred to as an encounter or visit vs. Admission/Discharge.. Geared more toward IP.

4. INPATIENT
Admitted to a hospital, including room & board and regular skilled nursing care and monitoring
Admission and discharge ordered by physician
Types of admission
Elective (planned direct admit)
Urgent, Emergency

5. OUTPATIENT / Ambulatory
Patient whose treatment is intended to take place in one day
On occasion may include overnight hours
SLIDE 3 – OUTPATIENT
Treatment/Services provided in a day (typically less than 24 hours). The treatment/services are received in a relatively short amount of time. In ambulatory settings the interaction between the pt and providers is referred to as an encounter or visit vs. Admission/Discharge.. Which is Geared more toward IP.

6. OUTPATIENT / Ambulatory
AMBULATORY CARE SETTINGS
Physician’s Office
Outpatient Department/Clinic
in an Acute Care – Hospital Setting
Urgent Care
Emergency Department - department of a hospital
SLIDE 4 - AMBULATORY CARE SETTINGS
Physician’s Office
Group practice – multiple physicians share an office – reduce costs for physicians for administrative costs, coverage for each other Single specialty
Multi specialty- ex: family practice with OB and a pediatrician
Emergency Department - department of a hospital
Handle crisis, acutely ill patients
Patients are “triaged” to determine priority – which case is more critical?
If pt is admitted within 72 hours of admission to the ER – Medicare will not pay separately – it is rolled into the IP stay
Outpatient Department/Clinic in an Acute Care – Hospital Setting
OP Rehab
Pain Clinic
Wound Care
Behavioral Health Care Settings
Partial hospitalization
Intensive Outpatient
Outpatient
Rehabilitation Facility
Physical medicine and rehabilitation – treat patients who suffered a debilitating illness or trauma or who are recovering from certain types of surgery
Ex: Care Accident; Stroke; hip/knee replacement;

7. Outpatient / ambulatory
Behavioral Health Care Settings
Rehabilitation Facilities

8. RESIDENT
Patients that are admitted to a facility that have an average length of stay of longer than 30 days. They typically need and receive care around the clock… NOTE: Behavioral Health is slightly different
A Resident is a person who is treated in
Long Term Care Facility
Behavioral Health