Admission and Eligibility
The physician determines the type of care his or her patient needs and whether the individual is eligible for in-patient hospital care. In addition to eligibility requirements for admission, there are also eligibility requirements for specific therapies, such as chemotherapy. There may be times when, although eligible for medical care, the patient's insurance does not cover a particular service. If an insurance carrier has denied a patient care, he or she can appeal the decision.
If an individual does not have health insurance, a representative from the financial office will be available to guide him or her through the process for applying for Medical Assistance.
Hospital admissions can be stressful, whether they are planned or sudden (the result of an emergency). Knowing what documents and other items to bring, and understanding the admission process, may lessen the stress.
- Insurance cards with policy numbers
- Insurance company address
- Claim forms (if you submit claims on your own behalf)
- Referral forms (particularly if a member of an HMO)
- Treatment authorization forms
- A copy of any advance directives
- A copy of the guardianship order, if applicable
Personal Items to Bring
- Nightclothes, bathrobe, and sturdy slippers
- Comfortable clothing to wear home
- A list of medicines, including over-the-counter medications
- Personal hygiene items: toothbrush, toothpaste, shampoo, comb, brush, deodorant, razor, etc.
- A small amount of money for items one may want to purchase (i.e. newspapers)
The admission process begins with an admission order from one's private physician or the emergency room physician. Understanding the admission process and paperwork for each type of admission is important and will make things run more smoothly.
Transfer to Another Hospital
After an individual has arrived at a hospital and been evaluated, the physician may determine that the patient needs medical care that is not offered at that particular hospital. The hospital is then responsible for ensuring transfer to an appropriate hospital. At times, a patient may choose to transfer to another hospital. In those cases, he or she may be responsible for paying the costs of the transportation and any medical care needed during the transfer.
If an admission is pre-planned, the patient will want to make an informed decision when choosing the hospital. The Joint Commission that offers accreditation to hospitals has developed a checklist that helps the consumer choose the right hospital.