Many York County residents are learning what hospital patients nationwide know: Being treated at the hospital doesn't always mean you were in the hospital. The difference might not be readily apparent. You'll see a nurse and probably a doctor. You might receive some tests, and you might even get a room for a night or two. But when it comes to the billing, you were never officially admitted. It's called "observation status," and insurance companies and Medicare are not as quick to pay bills related to that treatment status. That could mean a patient who assumes his insurance is covering the cost might end up with a big hospital bill.