Medicare Flashcards
Medicare A Benefit Period for Hospitalization:
First ____ days=Deductible
_____ to ____ days=Copay
For a total of _____ days
60
61-90
90
Reset for a new 90 day period, if there’s something different
Medicare Lifetime Reserve Days has max ____ days and can/cannot reset.
60, cannot
Skilled Nursing Facility Care Payment
Full for the first ___ days
Deductible for ____ to ____ days
No more after ___ days
20
20-100
100
Condition to qualify for medicare SNF care
1st receive inpatient hospital care for at least three nights or three, full 24 hour days
Must enter SNF within 30 days of that hospital stay
Same medical reason for the hospitalization
Care so inherently complex that only technical professional can provide
daily rehabilitate care under a medical plan
PPS
RUGs
Prospective Payment System
Resource Utilization Groups
Average medicare funded stay in a SNF used to be ____ days but now it’s _____ days
55
21
Medicare pays for home health care?
Yes, but only for limited, reasonable, and only medically necessary, skilled part time care, physical, occupational and other skilled therapies, home health aide services, speech language pathology and medical social services. Also medical equipments
Medicare B is _____ insurance
Medical
Four conditions for reimbursement of home health care services
- Dr determines that skilled medical care is needed at home
- Care is intermittent, skilled therapy (physical, speech/language, occupational etc)
- Agency must be approved by Medicare
- the Patient is homebound
Durable medical equipment covered under medicare part B requires ____% copay
20
HHC Home Health Care providers now receive a _____ fee
flat
What year did Balanced Budget Act become law
1997.
