November 16th quiz Flashcards
1
Q
What does part A cover
A
- hospital visits
- home health
- inpatient rehab
- SNF
- Hospice
2
Q
Admission to SNF requires?
A
3 day hospital stay w/in 30 days
3
Q
Minutes and care levels per week
A
-ultra high 720
-very high 500
-high 325
-medium 150
low 45
4
Q
What does part B cover?
A
Outpatient services
-labs, DM, HH, preventative, PT
5
Q
What does part C cover?
A
Medicare advantage, approved private insurance
6
Q
What does part D cover?
A
DRUGS!
7
Q
When are progress reports due?
A
- once on or before 10th trtmnt, no later than 30 days
- monthly note due every 30 days
- PT must write note
8
Q
Co treatments
A
- benefit pt, not convenience
- Part A - can each bill separately
- Part B- split time
9
Q
SNF Part B
A
- applies if pt does not have qualifying hospital stay
- room and board paid by pt
10
Q
Hospice
A
- terminal illness and 6 months or less to live
- give up curative treatments
- covers Pt
- 2 90 day periods, then unlimited 60 day
11
Q
5 requirements for home health coverage
A
- home bound
- skilled care on part time basis
- under care of doctor
- face to face encounter with doctor
- HHA must be medicare approved
12
Q
Homebound
A
- you cannot leave home and would require substantial effort
- medically inadvisable to leave home without help
13
Q
Therapy cap part B
A
- 1965 PT and Speech
- up to 3700 w/o review by medicare
14
Q
What is the most common error in fraud is?
A
insufficient documention
15
Q
Fraud examples
A
- systematic intentional deception
- upcoding,
