Outpatient Services | Kaiser Permanente (2023)

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What are outpatient services?

Outpatient services are medical procedures or tests that can be done in a medical center without an overnight stay. Many procedures and tests can be done in a few hours. Outpatient services include:

  • Wellness and prevention, such as counseling and weight-loss programs.
  • Diagnosis, such as lab tests and MRI scans.
  • Treatment, such as some surgeries and chemotherapy.
  • Rehabilitation, such as drug or alcohol rehab and physical therapy.

What are the benefits of choosing outpatient services?

Outpatient services usually cost less because you don't need to stay overnight. Staff members at outpatient centers are well trained in the service they provide. Most of the time, these centers specialize in one kind of treatment or procedure. Often all the care you need can be provided in one place.

Who uses outpatient services?

Most people can choose an outpatient center instead of a hospital if the needed service is available. But not all medical procedures can or should be done at an outpatient center.

How can you know if the outpatient center is trustworthy?

Try to find out all you can about the outpatient center before you use it. It's a good idea to visit the center before you decide.

Many health and government agencies rate or report on the quality of outpatient centers. Check with your state's board of medicine or with your insurance company to learn more.

You can also use the Quality Check website from The Joint Commission. For more information, go to www.qualitycheck.org.

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Types of Outpatient Services

More and more medical procedures are being offered in qualified outpatient service centers.

Outpatient services are offered in many settings. For instance, medical centers often provide various types of outpatient services, such as pain clinics or rehabilitation centers. Other types of outpatient facilities include:

  • Medical group practices.
  • Outpatient clinics at hospitals or other medical facilities.
  • Surgery centers.
  • Imaging centers.
  • Cardiac catheterization centers.
  • Mental or behavioral health centers, which may provide substance use treatment services and mental health services for adults or children.
  • Lab centers.
  • Gastrointestinal centers, which may provide screening or other services such as colonoscopy and endoscopy.
  • Durable medical equipment rental facilities.
  • Physical therapy centers.
  • Chemotherapy and radiation therapy centers.

Many outpatient service centers specialize in a specific area of medicine, such as orthopedics (bones) or cardiology (heart). These centers, like many hospitals, have advanced equipment and highly trained staff.

Benefits of Outpatient Services

There are many benefits to outpatient services, depending on the type of medical procedure you need and on what you prefer.

  • Outpatient services can be cost-effective. Often, the procedure that you need may cost less at an outpatient service center than at a hospital, especially since you are not billed for separate hospital services. Outpatient service centers do not require an overnight stay. This can reduce costs.
  • Outpatient service centers usually specialize in one type of treatment or procedure. And the staff usually has a lot of experience that is focused on the procedure you need. Also, the equipment and techniques used may be the most advanced.
  • Outpatient services may be more convenient for you. All of the care that you need before, during, and after the procedure, surgery, or test may be conveniently provided in one place.

Quality of Outpatient Services

Try to find out all you can about the outpatient center before you use it. It's a good idea to visit the center before you decide.

Most outpatient service centers are accredited and approved for the types of treatment offered. But not all centers provide care that is right for you. Be sure to find out whether the provider you're considering is reputable and qualified. The following government and health agencies can help you learn about the quality of outpatient service centers:

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  • Quality Check, a service of The Joint Commission on Accreditation of Healthcare Organizations. You can contact this organization by phone at (630) 792-5000. Or go to www.qualitycheck.org to visit their website.
  • Your state's board of medicine. Every state in the United States has a state board of medicine that regulates complaints against medical facilities and doctors. Although this agency will not reveal the details about any facility or individual, you can find out if there have been complaints filed against a facility or doctor. You can find your state board of medicine through the local telephone directory. Or go online and search for "Board of Medicine" for your particular state.
  • COLA. This group oversees the accreditation for laboratories and testing centers. Go to www.cola.org for information.
  • The American Osteopathic Association. This agency monitors approval of professional services by osteopathic physicians. You can find this agency through your local telephone directory. Or go to www.osteopathic.org to visit their website.
  • Your insurance carrier. Many insurance carriers keep quality indicator records for doctors and facilities in your local area.

Finding the Right Provider

It is important to check with your health insurance provider to determine what outpatient services are covered. Your particular health plan coverage may limit your choice of services.

Choosing a quality outpatient center before you have a medical procedure is the best way to make sure that you'll receive excellent care. Friends and family who have used outpatient services may tell you about their personal experiences. Often your doctor will know about the quality of outpatient services in your area. You may want to start your search by talking with your doctor about your options. Next, find out which outpatient services are covered by your insurance company. The following questions may help you find the outpatient service center that best fits your needs:

  • Does the facility accept your health insurance? Does your insurance cover any or all of the costs?
  • Is the outpatient service center conveniently located or within a reasonable distance of your home or work?
  • Is more than one facility in your area qualified to provide the service you need?
  • Will the facility communicate well with your doctor and provide the information you need in a timely manner? Can your doctor verify the accuracy of any tests you had?
  • Is the outpatient service center accredited by a national medical board or other recognized agency? You can find out by calling your state medical board or The Joint Commission.
  • Is the facility clean, organized, comfortable, and private? You'll need to visit the facility to find out. You may want to ask the facility or others who have used the facility if the recovery room is well-staffed. Is there a waiting room for your family?
  • Is information readily available to you? Will you receive instructions before, during, and after a procedure or test?
  • Are brochures or literature available that explain the outpatient center's services and fees? Does the facility provide information on financial assistance?
  • Do you have other health conditions that should be considered? Can the facility accommodate treating your other conditions if needed? Does your doctor think there is a risk that you may need specialized attention or emergency services during the procedure?
  • Does the center have all of the possible equipment and knowledge it needs to treat you in case of an emergency during your procedure, test, or surgery—such as problems with anesthesia during surgery or your newborn needing intensive care after delivery? If you have other health conditions, you may be at higher risk for needing emergency care.
  • Is the center connected to a major hospital, in case you need emergency care. How far away is the hospital?
  • Can you get all the care you need at the facility? Will the center provide all the medicines or other treatment needed? Will you have to go somewhere else for follow-up care?
  • What kind of experience does the staff have? How long has the outpatient service center been operating? What are the specialties of the doctors providing the care? Are they board-certified in their specialty areas?

You may have more questions based on your own health issues and the type of procedure or test you need. Ask questions, listen to the recommendation of your doctor and those you trust, and visit the facility to get the information you need to make the best decision for your health care.

Related Information

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  • Choosing a Health Care Provider
  • Medical Specialists
  • Pediatric Preparation for Medical Tests
  • Prevent Medical Errors
  • Smart Decisions: Know Your Options
  • Surgery: What to Expect
  • Understanding Health Insurance
  • Work Closely With Your Doctor


Current as of: March 9, 2022

Author: Healthwise Staff
Medical Review:
Anne C. Poinier MD - Internal Medicine
Adam Husney MD - Family Medicine
E. Gregory Thompson MD - Internal Medicine

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    Types of Outpatient Services

Current as of: March 9, 2022

Author: Healthwise Staff

Medical Review:Anne C. Poinier MD - Internal Medicine & Adam Husney MD - Family Medicine & E. Gregory Thompson MD - Internal Medicine


What are examples of outpatient services? ›

Outpatient care examples
  • X-rays, MRIs, CT scans, and other types of imaging.
  • Lab tests, such as bloodwork.
  • Minor surgeries, particularly ones that use less invasive techniques.
  • Colonoscopies.
  • Mammograms.
  • Consultations or follow-ups with a specialist.
  • Routine physical exams.
May 13, 2021

What are the three types of outpatient? ›

Types of Outpatient Care Patients
  • Primary Care Clinic. Primary care clinics are where patients go to be seen by their primary care physicians (or PCPs). ...
  • Community Health Clinic. Community health clinics offer primary care services to patients whose access to healthcare is limited. ...
  • Urgent Care Center.
Oct 30, 2021

What are the outpatient services What are the advantages of using outpatient services? ›

What are the benefits of choosing outpatient services? Outpatient services usually cost less because you don't need to stay overnight. Staff members at outpatient centers are well trained in the service they provide. Most of the time, these centers specialize in one kind of treatment or procedure.

How do I fight Kaiser Permanente? ›

Kaiser patients cannot usually sue for medical negligence. Instead, they must go through binding arbitration. Kaiser Permanente patients wishing to bring an action against a Kaiser health care provider for medical negligence must usually go through Kaiser's arbitration process.

What means outpatient services? ›

Outpatient care, also called ambulatory care, is anything that doesn't require hospitalization. An annual exam with your primary care physician and a consultation with your neurologist are both examples of outpatient care. But emergent cases can also be considered outpatient care.

What are the five main types of outpatient services? ›

What are the five main types of hospital-based outpatient services?
Terms in this set (25)
  • Wellness and Prevention (counseling)
  • Diagnosis (lab tests)
  • Treatment (surgery)
  • Rehabilitation (PT)

What is considered an outpatient procedure? ›

Outpatient surgery is when you have a surgical procedure done and then later that same day you go home. Outpatient surgery can also be called ​“same-day” surgery or ambulatory surgery. Inpatient surgery, on the other hand, is when you have surgery and are required to spend at least one night in the hospital.

What is the purpose of outpatient? ›

In outpatient treatment, patients receive mental health services in an office or clinical setting rather than being admitted to the hospital overnight. For patients who do not need round-the-clock care, outpatient treatment is an excellent option.

What is the role of outpatient department? ›

An outpatient department or outpatient clinic is the part of a hospital designed for the treatment of outpatients, people with health problems who visit the hospital for diagnosis or treatment, but do not at this time require a bed or to be admitted for overnight care.

Why do people prefer outpatient services? ›

Reduced Costs:

Not only is an outpatient clinic less expensive to build than a hospital, but operating costs associated with over night stays, mechanical, electrical systems and more are reduced as well.

Why is outpatient care better than inpatient? ›

Outpatient surgeries are usually much less complicated than inpatient surgeries. This means that patients are discharged home after their procedure. Inpatient surgeries are more complex thus, patients must stay in the hospital to be monitored by health professionals.

What provides care on an outpatient basis? ›

These services are administered in a variety of different outpatient facilities. Some examples include primary care clinics, community health centers, urgent care clinics, ambulatory surgery centers, and even some pharmacies for basic healthcare consultations and immunizations.

Is there a class action suit against Kaiser Permanente? ›

On April 22, 2021, a class action lawsuit was filed against Kaiser Foundation Health Plan, Inc., Kaiser Foundation Hospitals, The Permanente Medical Group, Inc., and Southern California Permanente Medical Group in the Superior Court of San Francisco County that makes claims for: (i) unequal pay based on race; (ii) ...

Can Kaiser deny coverage? ›

Kaiser Permanente and other health management organizations often deny health insurance claims for the following reasons: A service or procedure is not covered under the claimant's policy. A procedure is considered experimental, cosmetic, or is intended for investigation.

What is arbitration with Kaiser Permanente? ›

In a Kaiser arbitration, the person bringing the claim (“Claimant”) and Kaiser both have lawyers, and the process is carried out much like a civil trial. Each side is required to present evidence and witnesses, including medical experts. There is no jury. The neutral arbitrator acts as both the judge and jury.

What does outpatient only mean? ›

What does it mean to be in outpatient care? Outpatient care is defined as hospital or medical facility care that you receive without being admitted or for a stay of less than 24 hours (even if this stay occurs overnight).

What is another term for outpatient services? ›

▲ (healthcare) Provided without requiring an overnight stay by the patient. ambulatory.

What are the 8 types of patient care services? ›

Types of Services
  • Mental health care.
  • Dental care.
  • Laboratory and diagnostic care.
  • Substance abuse treatment.
  • Preventative care.
  • Physical and occupational therapy.
  • Nutritional support.
  • Pharmaceutical care.
Jan 21, 2022

What are the two services provided by outpatient department? ›

Answer: These include diagnostic and treatment functions, such as clinical laboratories, imaging, emergency rooms, and surgery; hospitality functions, such as food service and housekeeping; and the fundamental inpatient care or bed-related function.

Which is belong to outpatient? ›

Outpatient hospitalisation implies the medical care provided to patients who do not need to be hospitalised. It typically includes diagnostic tests, doctor consultations, patient rehabilitation and post–treatment follow–ups, and so on.

What is the difference between in patient care and outpatient care? ›

What's the main difference between inpatient and outpatient care? Generally speaking, inpatient care requires you to stay in a hospital and outpatient care does not. The big difference is whether you need to be hospitalized or not.

What is the difference between office visit and outpatient? ›

The main difference between outpatient and office visits is the cost. You'll receive the same care from your doctor regardless of the facility being used, but outpatient facilities sometimes charge patients additional hospital affiliation fees.

What are the disadvantages of outpatient care? ›

Cons of an Outpatient Level of Care
  • Lacks Medical Detox. ...
  • Does Not Provide 24-hour Supervision. ...
  • Requires Family Involvement.
Oct 27, 2022

Why are outpatient services popular with consumers? ›

These days, patients prefer to have their knee replacement surgeries, cataract surgeries, colonoscopies, and mammograms (to name a few) performed in the outpatient setting due to the associated ease, convenience, and price point.

What is the risk of outpatient procedure? ›

The most frequent complications include nausea and vomiting, sore throat, and discomfort at the surgical site. Although more serious complications are rare, heart attack, stroke, excessive bleeding, and even death have occurred in the outpatient setting. Some people may require hospital admission following surgery.

Why do payers prefer patients to use outpatient services rather than inpatient services? ›

Patients prefer faster access, shorter stays, and lower costs. Payers typically pay significantly less for the same procedure than they would at an inpatient facility.

Which of the following is one of the reasons why outpatient services have increased? ›

Outpatient services are growing in popularity for two main reasons. First, they are less expensive than hospitals, which have much higher overhead costs. The second reason is that medical improvements have made outpatient services far more practical.

Which is easier to code inpatient or outpatient? ›

Inpatient coding is more complex than outpatient coding. Inpatient codes report the full range of services provided to the patient over an extended period of time or the period of hospitalization. Inpatient coding also comes with a present on admission (POA) reporting requirement.

Is it a good idea to join a class action lawsuit? ›

Even in cases with minor damages, it may be worth your time, money, and resources to join a class action lawsuit. If you have minor injuries or other damages from a large company's negligence, these issues can affect many other people, too.

What counts as medical negligence? ›

Medical negligence is substandard care that's been provided by a medical professional to a patient, which has directly caused injury or caused an existing condition to get worse. There's a number of ways that medical negligence can happen such as misdiagnosis, incorrect treatment or surgical mistakes.

Has Kaiser been sued for misdiagnosis? ›

Hodes Milman Secures $17.25 Million Award for Kaiser Medical Misdiagnosis. A skilled attorney is essential when negotiating with large, powerful insurance company lawyers on their own turf.

Why would you be denied health insurance? ›

Summary. There are a wide range of reasons for claim denials and prior authorization denials. Some are due to errors, some are due to coverage issues, and some are due to a failure to follow the steps required by the health plan, such as prior authorization or step therapy.

Why would an insurance company deny coverage? ›

Companies will refuse to approve your request for compensation if your claim lacks support and evidence. The insurer may justify its denial by claiming that it believes your injuries were pre-existing at the time of the accident or that your own conduct made the injuries worse.

Can you be rejected for health insurance? ›

Coverage for pre-existing conditions

No insurance plan can reject you, charge you more, or refuse to pay for essential health benefits for any condition you had before your coverage started. Once you're enrolled, the plan can't deny you coverage or raise your rates based only on your health.

Should I agree to arbitration? ›

The advantages include the following: The arbitration process is less costly and generally faster than going through the courts. Unlike in a court case, where the contested issue is heard before a judge, in an arbitration you often have a say over who will be the arbitrator.

Is it good to go to arbitration? ›

Most of the time, but not always the case, arbitration is a lot less expensive than litigation. Arbitration is often resolved much more quickly than court proceedings, so attorney fees are reduced. Also, there are lower costs in preparing for the arbitration than there are in preparing for a jury trial.

Who pays for Kaiser arbitration? ›

In most Kaiser malpractice arbitrations, if the case is being heard by a single neutral arbitrator and the claimant agrees to waive any objections that may arise out of how the arbitrator is being paid, then the Kaiser respondents will pay for the fees and expenses incurred by the neutral arbitrator in hearing the case ...

What are the categories of outpatient services in the hospital? ›

What are the 6 Different Types of Outpatient Services?
  • Emergency Outpatient:
  • Referred Outpatient:
  • General Outpatient:
  • Outpatient Visit:
  • Unit of Service:
  • Service Time:

What is considered an outpatient setting? ›

An Outpatient Surgery Setting is any facility, clinic, center, office, or other setting that is not part of a general acute care facility, where anesthesia is used in compliance with the community standard of practice.

How many outpatient appointments are there? ›

In 2021-22, there were 122.3 million outpatient appointments.

What are the objectives of outpatient services? ›

The outpatient department of a hospital provides diagnosis and care for patients that do not need to stay overnight.

What is inpatient vs outpatient services? ›

An inpatient is a hospital patient who, in most cases, stays in the hospital overnight and meets a set of clinical criteria. Outpatients are people who receive care or hospital services and return home the same day.

What is not an outpatient setting? ›

Generally, inpatient care refers to medical care that occurs when a patient is admitted into the hospital, while outpatient refers to medical care that is received while a patient is not admitted into the hospital.

Why are outpatient services so popular? ›

Not only is an outpatient clinic less expensive to build than a hospital, but operating costs associated with over night stays, mechanical, electrical systems and more are reduced as well. Reimbursement: Due to the nature of reimbursement, hospitals make more money from patients who don't need to stay overnight.


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