Medicare tagged posts

Long Term Care Insurance? Act Before it is Too Late

Long-term care

Long Term Care Insurance? Act Before it is Too Late

Long Term Care Insurance? Act Before it is Too Late

We generally do not think about long-term care until and when we experience it in our lives. Oftentimes it takes the form of a loved one (typically a parent) who becomes suddenly disabled and the family (typically the children) steps in to assist. That assistance soon begins to take more and more of our time, affecting our jobs, our own families, and ultimately our lives. When this happens we all become fast studies in the field of long term care and, unfortunately, when there is inadequate planning, it is often too late. We are transformed from loved ones into long term care providers...

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Nurse Ratio Legislation Needed

Nursing

Nurse Ratio Legislation Needed

Nurse Ratio Legislation Needed

American health care is being seriously squeezed by a nursing shortage. The number of aging Americans requiring more healthcare is increasing, while the number of registered nurses is decreasing. Because of the shortage, nurses often work longer hours with much heavier patient loads than they have in the past. Various plans have been proposed to provide sufficient nurse staffing. Many groups, including the American Nurses Association (ANA) are fighting for legislation that would set nurse staffing ratios.

Several studies have shown that inadequate staffing of nurses has a serious, detrimental effect on patient care and health...

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Understanding Medicaid Coverage of Long Term Care

edicaid

Understanding Medicaid Coverage of Long Term Care

Understanding Medicaid Coverage of Long Term Care

It is important to understand Medicaid coverage for long term care so that one can avail themselves of this program if needed. Medicaid is considered the country’s largest public payer of long-term care. Once a person is determined to be qualified for its coverage, this government-supported program will pay for the nursing home care and other expenditures Medicare does not cover. It certain situations, it may also aid assistance for specific LTC services provided at home.

How to qualify for Medicaid? There are several ways on how you can qualify for Medicaid coverage. Once you receive Supplem...

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Long Term Care and How to Pay for It

Longterm Care

Long Term Care and How to Pay for It

Long Term Care and How to Pay for It

Long term care and how to pay for it must be addressed well in advance of the actual need. Long-term care, the care needed in the near future, perhaps because of permanent conditions such as arthritis, stroke or dementia. It may mean help, such as washing, dressing or eating – in your own homes or in nursing homes.

As you age, you may develop health problems that could make it difficult to cope with daily tasks. So, there is a big possibility that one day you might need help and assistance to stay in your own home or move into a nursing home.

Every State can provide little help to cover this treatment, depending on y...

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Medicare Supplement Plans Have Guaranteed Issue Periods

Medicare

Medicare Supplement Plans Have Guaranteed Issue Periods

Medicare Supplement Plans Have Guaranteed Issue Periods

Medicare Supplement plans have guaranteed issue periods that allow individuals to apply for a plan without denying you coverage, excluding your pre-existing conditions, or charging you more because of any health conditions. These guaranteed issue (GI) rights are Federally-mandated by the Centers for Medicare & Medicaid Services and apply to you all Medicare-enrollees who are in one of these specific situations.

The GI rights generally occur when your current health care coverage is changing in a certain way or you are involuntarily losing your coverage...

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Long Term Care, Its Role And Objective

l

Long Term Care, Its Role And Objective

Long Term Care

Long Term Care, Its Role And Objective

Long term care, its role and objectives have been set by the Federal government on a national basis. Long-term care is a range of services and supports to meet health or personal care over a longer period. Most long-term care is non-skilled personal care assistance such as help performing basic daily living activities (ADLs) which include bathing, dressing, using the toilet, eating and the likes.

The objective of long-term services is to help particular individuals maximize their independence and functioning at a time when they cannot be totally independent...

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Supplemental Health Insurance Resources Online

nsurance

Supplemental Health Insurance Resources Online

Supplemental Health Insurance Resources Online

Supplemental health insurance resources on line can help you understand the rules, regulations and stipulations often by carriers and their different policies. The policies use terms that one without specific insurance background might find unclear and confusing. Words such as co-payment, deductible, family allowance, preventative vs. routine care often times add confusion. Ā Health Insurance in general is difficult to understand and often leads us to believe we are being manipulated...

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Do-Not-Hospitalize Orders Rarely Used

Do-Not-Hospitalize Orders Rarely Used

Do-Not-Hospitalize Orders Rarely Used

Do-Not-Hospitalize Orders Rarely Used

Do-not-hospitalize orders rarely used, but they could cut unnecessary hospital stays for skilled nursing facility residents. The use of the do-not-hospitalize order cuts emergency department visits and hospital stays according to new research.

Researchers from Rutgers University and the State University of New York at Albany analyzed data from over 6,000 nursing facility residents to determine the impact of DNH orders. Their findings showed that 61% of residents had a do-not-resuscitate order and only 12% had a do-not-hospitalize order in their medical charts.

Residents with the DNH order had significantly fewer unne...

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Missing Payroll Based Journaling Deadlines Will Effect Ratings

Missing Payroll Based Journaling Deadlines Will Effect Ratings

Missing Payroll Based Journaling Deadlines Will Effect Ratings

Missing Payroll Based Journaling Deadlines Will Effect Ratings

Nursing Facilities missing payroll based journaling deadlines will effect their Five Star ratings if they miss two deadlines in a row. The Centers for Medicare and Medicaid issued this warning earlier this week. This warning comes only two weeks prior to the May 15th submission deadline for data from the second fiscal quarter.

Officials from the Centers from Medicare and Medicaid warned skilled Nursing facility operators that they should not wait to the last minute to submit staffing data...

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Medicare Supplement Plan Selection Process

Medicare Supplement Plan Selection Process

Medicare Supplement Plan Selection Process

Medicare Supplement Plan Selection Process

The Medicare supplement plan selection process is a confusing and timely one. Many Medicare recipients need additional coverage for the items that Medicare does not cover. Here are steps to help you select the Medicare Supplement Quotes that is right for you. The following analysis leads to making a wise decision as to which Medicare supplement insurance company and plan is right for you.

Medicare supplement health care plans are sold by private companies. There are 12 standard Medicare supplement health care policies– named plan A – plan L...

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Emergency and Urgent Care Medicine

Emergency and Urgent Care Medicine

Emergency and Urgent Care Medicine

Emergency and Urgent Care Medicine

Emergency and urgent care medicine is changing. Here in the this country, there are in the region of thirty thousand Hospitalists active today. Just about half of hospitals across the land have a branch of this specialized unit. Many medical education institutions, such as colleges and universities, are beginning to develop Hospitalist-based residency programs. Hospitalists have a very narrow and contemporary history: in the last decade or so, a forte for a broad and intense, hospital based specialty emerged...

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Medicare Telehealth Coverage to be Expanded

Medicare Telehealth Coverage to be Expanded

Medicare Telehealth Coverage to be Expanded

Medicare Telehealth Coverage to be Expanded

Medicare telehealth coverage to be expanded. A bipartisan group of Senators is introducing a bill to increase Medicare coverage for Telehealth services.

The Telehealth Innovation and Improvement Act, was proposed by Senator Cory Gardner (R-CO) and Gary Peters (D-MI), would require the Center for Medicare and Medicaid Services to test the inclusion of Telehealth services for Medicare programs. This would include providing reimbursement for these services...

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Senate Committee to Reintroduce Medicare Audits Appeal Bill

Senate Committee to Reintroduce Medicare Audits Appeal Bill

Senate Committee to Reintroduce Medicare Audits Appeal Bill

Senate Committee to Reintroduce Medicare Audits Appeal Bill

The Senate Committee to reintroduce Medicare audit appeal bill shortly.

The Audit &Appeals Fairness, Integrity, and Reforms in Medicare Act, was introduced in late 2015. It was designed to help combat the growing backlog of Medicare claim appeals. the original bill pledged $125 million for OMHA, and $2 million to the Department Appeals Board of the Department of health and human services, to fund reviews, hearings and provider appeals.

This bill when reintroduced will be applauded by providers at all levels...

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Four Levels of Care Provided by Hospice

Four Levels of Care Provided by Hospice

There are four levels of care provided by hospices in the United States. Every patient receiving hospice services will be on one of these four levels. A hospice patient can move from one level to another and back, depending on the services required to fulfill his or her needs. The need of the patient will determine their individual level of care.

Four Levels of Care Provided by Hospice

Four Levels of Care Provided by Hospice

Routine Home Care – Patient at home with symptoms controlled

A patient will be placed at this level of care if he or she resides at home (or a long-term care facility) and does not have symptoms which are out of control...

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Medicare Bundled Payment Initiative

Medicare Bundled Payment Initiative - Since 2013

Medicare Bundled Payment Initiative

Medicare Bundled Payment Initiative

The bundled payment initiative is one of the best hopes for reducing healthcare costs. The Affordable Care Act (ACA) came up with several Provider payments models, including Value-based Purchasing (VBP), patient-centered medical homes, and Accountable Care Organizations (ACO). Among these payment models, the Bundled Payment Initiative was cited as one of the best models in improving healthcare quality and efficiency. Although this initiative made the Providers to struggle through the new payment model adoption and tackling of physician billing services, it attracted many participants...
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Lawmakers Offer New Bill To Include Observation Days Toward SNF Coverage

Lawmakers Offer New Bill To Include Observation Days Toward SNF Coverage

Lawmakers Offer New Bill To Include Observation Days Toward SNF Coverage

Lawmakers Offer New Bill To Include Observation Days Toward SNF Coverage

A bipartisan group of lawmakers offer new bill to include observation days toward SNF coverage. The bill would make it mandatory that days spent in hospitals in observation status would count toward the three day inpatient stay required for skilled nursing coverage.

The new bill, Improving Access to Medicare Coverage Act had a predecessor in 2015. The new bill was introduced by a bipartisan group of legislators including, Reps...

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Home Health Agencies Under New Rules

Home Health Agencies Under New Rules

Home Health Agencies Under New Rules

Home Health Agencies Under New Rules

Home health agencies under new rules as of last month. New conditions for 12,600 home health agencies to participate in Medicare and Medicaid have been published and they go into effect this July. The new rules may be delayed as the Trump administration has asked for time to review them before implementation. The estimated cost associated with implementation that the agencies will have to absorb is $293 million in year one and $234 million a year thereafter.

Home health services under Medicare are available to seniors or adults with disabilities who are home bound and have a need that has been certified by a physician...

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Nurse Practitioner’s Growing Role in LTC

Nurse Practitioner's Growing Role in LTC

Nurse Practitioner’s Growing Role in LTC

Nurse Practitioner’s Growing Role in LTC

Nurse practitioner’s growing role in LTC is primarily based on the higher patient acuity we are seeing that requires a greater clinical presence. NP’s are capable of meeting the Centers for Medicare and Medicaid Services goals of improving quality of care, patient satisfaction and cost of care. In the LTC setting they can act as a gate keeper with the goal of reducing readmissions to hospitals.

Nurse practitioner’s have been authorized to provide Medicare services to subacute and long term care facilities for over 30 years. They receive 85% of a doctors reimbursement...

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Emergency Room Surprise Billing

Emergency Room Surprise Billing

Emergency Room Surprise Billing

Emergency Room Surprise Billing

For most people a visit to an emergency room carries sufficient stress. As many as twenty percent (20%) of emergency room patients receive additional trauma in the form of an unanticipated medical bill– in more than a few cases for thousands of dollars.
Patients who are forced to use the emergency services in a hospital, even one that is within their insurance network have a twenty percent (20%) of seeing an out-of-network ER doctor who may bill them for his services according to the New England Journal of Medicine.
The article was based on a sample size of over 2...

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