Nov. 26, 2019
-
- Home
- Network Participation
- Claims and Eligibility
Claims and Eligibility
- Claims and Eligibility
- Electronic Commerce
- Eligibility and Benefits
- Utilization Management
- Prior Authorization and Recommended Clinical Review
- How to Request Prior Authorization and Recommended Clinical Review
- Prior Authorization Lists
- Claim Submission
- Claim Payment
- Claim Review and Appeal
- Refund Management
- ClaimsXten
- Evicore
- Interactive Voice Response (IVR) System
- Carelon
- Education and Reference
- Clinical Resources
- Pharmacy Program
- Standards and Requirements
- Availity® Essentials Portal
- Employers
- Producers
- Providers
- Company Information
Annual Reminder: Medicare Outpatient Observation Notice Required
As of March 8, 2017, hospitals and Critical Access Hospitals (CAH) must give the standardized Medicare Outpatient Observation Notice (MOON) to people who receive Medicare benefits and are observed as outpatients for more than 24 hours. This includes people with Blue Cross Medicare Advantage (PPO)SM, Blue Cross Group Medicare Advantage (PPO)SM and Blue Cross Group Medicare Advantage Open Access (PPO)SM health plans.
This notice lets people know why they are not considered to be inpatient and what their cost sharing and hospital coverage will be. It must be explained verbally and completed no later than 36 hours after observation begins or sooner if patients are admitted, transferred or released. Patients must sign to confirm they received and understand the notice. If they say no, the staff member who gave the patient the notice must certify that it was presented.
The MOON and what to do with it can be found Online.
The information provided here is only intended to be a summary of the law that have been enacted and is not intended to be an exhaustive description of the law or a legal opinion of such law. If you have any questions regarding the law mentioned here, you should consult with your legal advisor.