Post Acute Care
What is Home Health?
How many days of SNF coverage at 100% does the average Medicare patient have.
What is 20 days?
This form is used to notify patients of their right to appeal their discharge if they do not agree with the plan.
What is the Important Message from Medicare (IMM)
Patients who appeal their discharge with the QIO and lose their appeal become financially responsible for the remainder of their stay at what time?
This type on insurance is federally funded and conditions of participation are the same in all U.S. states.
What is Medicare?
Services provided in this type of facility include; 24 hour care and supervision under the care of a RN and a Medical Doctor or Medical Director and include skilled services, such as tube feedings, IV antibiotics, PT/OT/ST, and wound care.
What is a skilled nursing facility?
This type of insurance plan provides Medicaid coverage, but is managed by private companies that have contracted with Medicaid.
What are Managed Medicaid Plans.
The second IMM must be delivered following these timeframes.
What is within two days of discharge and no later than 4 hours prior to leaving?
Patients with traditional Medicare insurance require this many days for a stay of wellness out of the hospital or post-acute facility in order for their benefit to reset.
What is a 60-day stay of wellness?
This type of insurance is partially funded at the federal level, but mostly funded at the state level and is considered state specific.
What is Medicaid?
Name three of the four levels of care offered by hospice as defined by Medicare.
What are Routine Home, Continuous Home, General Inpatient, and respite?
This is not covered by Medicare for patient who admit to a SNF under hospice.
What is room and board?
What is anything not covered under the hospice diagnosis?
This form must be delivered to all patients who are in observation status for at least 24 hours.
What is the Medicare Outpatient Observation Notice?
Patients who wish to pursue a second appeal of their discharge following a lost first appeal in that same stay will be financially responsible for their hospital stay starting at this day/time if they lose the second appeal?
What is noon the day following loss of the first appeal?
This type of plan provides Medicare coverage to individuals and families, but is managed by private companies that have contracted with Medicaid.
What is a Medicare Advantage Plan?
This type of rehab facility requires patients be able to perform a minimum of three hours of therapy per day and that they need at least two out of the three therapies (PT/OT/ST).
What is Acute Rehab?
This is the percentage for which Medicare pay for days 21-100 at a SNF?
What is 80%?
Delivery of the MOON must occur no later than how many hours after the Obs order is written?
What is 36 hours?
Name three of the four types of social security benefits that a person might be receiving.
What is Supplemental Security Income (SSI), Social Security Disability Insurance (SSDI), Social Security Retirement, and Social Security Survivors Benefit.
A resident of the state of Virginia, a U.S. national, citizen, permanent resident, or legal alien, in need of health care/insurance assistance, whose financial situation would be characterized as low income or very low income and also meet one of the following:
Should qualify for which insurance
What is Medicaid?
This type of facility is often associated with pulmonary/vent specialized care and medially complex patients , such as those with HIV/Aids, renal failure, CAD, CHF etc. that require more intensive therapies and nursing care.
What is a Long Term Acute Care Hospital (LTAC/LTACH)?
This insurance requires a 3 midnight inpatient stay prior to discharge to a SNF.
What is traditional Medicare?
This form must be delivered to all Tricare patients within two days prior to discharge.
What is the Important Message from Tricare (IMT)
This organization is the QIO that manages patient hospital discharge appeals.
What is Livanta?
This process is used to convert an IP order to Observation for traditional Medicare patients.
What is the Code 44 process?