Revised Medicare Order Forms

MedicareHCA has revised the Medicare Order Form based on feedback received from physicians and others.  While hospitals and physicians have done an excellent job with the current form, the new version has been streamlined to facilitate its understanding and completion.

Please replace the current Medicare Order Form with the versions below dated 02/05/14 no later than March 1.  An instructional guide is also attached and will provide tips on how to complete the Medicare Order Form. 

MOF Guide          Medicare Order Form

Physicians must use the Medicare Order Form for all traditional Medicare patients to order patient status (inpatient, outpatient, outpatient status and begin observation services) and to certify an inpatient stay. A new Medicare Order Form should be used when progressing a patient from outpatient to inpatient status.


 Key changes to the form:

•Only two sections –IP and OP/OBS

•If patient converts from OP/OBS to IP, use new form

•ED physician now uses telephone/verbal order line vs. having separate

  line, and they can still sign in their own right for OP/OBS services.

CMS clarifications:

•No differentiation between OP/OBS and IP level care

•If hospital care is necessary, use time-based standard for IP or OP/OBS

•OP/OBS > two midnights should be converted to IP

•Can do so even if discharge is imminent as long as care met two midnights and       

  patient required hospital care

•Inpatients with less than two midnights should be a rare and unusual circumstance

•OP/OBS approaching two midnights

•Patients receiving care exceeding two midnights should be inpatient

 Should you have any questions, please contact Case Management.  Kristen Green can be reached at 540-498-4487 and Melissa Vance can be reached at 540-498-4835.

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