Medicare Background
These are the reasons a patient can qualify for Medicare.
What is age, disability, or ESRD?
This is how often a the MSP tab must be completed.
What is every time a patient uses Medicare?
This person is always the subscriber for Medicare.
Who is the patient?
What is Medicare Advantage only?
This is how ED staff knows a patient is being admitted for SDC, observation or inpatient.
What is that the regulatory requirements icon appears in FirstNet?
This is the federal agency that oversees Medicare.
What is CMS?
If the patient answers "no" to all questions on the MSPQ, this insurance is most likely billed first (primary).
What is Medicare?
If the patient says the VA is going to pay for the visit and the patient also has Medicare, this is the COB.
What is VA Hospital (primary), Medicare (secondary)?
A patient has a Blue Cross/Blue Shield Medicare Advantage that is not listed in our system. The user loads it by doing this.
Looking at the Blues Medicare Advantage chart.
This conversation is used to process admits.
These are the four parts of Medicare.
What is Medicare A, Medicare B, Medicare C and Medicare D?
This "reason" tells the user which coordination of benefits rules to follow.
What is the Medicare eligibility reason? (Age, Disability and/or ESRD)
This website will tell us if Medicare is active and if the patient has a Medicare Advantage.
What is MyAbility?
If a patient has a Medicare Advantage that is not listed in our system by name and it is not Blue Cross/Blue Shield, the user must choose between these two plans to load it manually.
What is Misc Medicare Advantage Managed Care and Misc Medicare Advantage FFS?
This form must be presented in person and the patient must receive a paper copy (even though the form is electronic).
What is the Important Message from Medicare?
The letter on the end of an old Medicare card means this.
What is to whom does the SSN belong to?
If an insurance is through a current employer and meets group size requirements, it is considered to be this.
What is a GHP (group health plan)?
This additional question must be asked of all Medicare patients (not part of the MSPQ).
What is prior stays?
This is the amount of copay that is collected for a Medicare Advantage patient.
What varies by payer?
This must be added to the Medicare Advantage screen if the Medicare Advantage patient has become an inpatient.
What is the HIC/MBI number?
These two parts work together to create "traditional" or "regular" Medicare.
What is Medicare A and B?
Adding 3 months to the dialysis start date for ESRD patients gives the user this estimated date.
What is the 30 month coordination start date?
This kind of commercial product is sold to be people who have Medicare. It typically helps pay for the 20% co-insurance and is always loaded secondary to Medicare.
What is a Medicare supplement?
The patient has active Medicare and active Keystone Senior Blue. This is the correct COB.
What is Keystone Senior Blue only?
Bonus: Keystone Senior Blue is loaded as what in our system?
These patients sign the MOON.
What is observation patients who have Medicare or a Medicare Advantage?