Wgu Kot1 Task2
Task 2
SUBDOMAIN 734.3 - ORGANIZATIONAL SYSTEMS & QUALITY LEADERSHIP.
Competency 734.3.4: Healthcare Utilization and Finance
A1-Which costs will be covered by Medicare Part A?
Medicare Part A is otherwise called the Hospital Insurance and covers up to 100 days of the Skilled Nursing Facility stay. To be qualified for it the patient first has to have been hospitalized for more than 3 days in a hospital (qualifying hospital stay) so the stay in it would not be considered outpatient. After the hospital stay the doctor that followed the patient in the hospital or the PCP that releases the patient from the hospital needs to write the order for the SNF services. In order for a patient to receive the services from the SNF they have to:
-Have Medicare Part A insurance
-Have days left in the benefit period
-The SNF receiving the services from is Medicare certified
-Be in the SNF because of the need for daily skilled care which the SNF can provide
-Receive the services rendered daily even though sometimes offered 5-6 days only
-Have a condition that started during the stay in the SNF after being admitted for a hospital related medical condition (in this case stroke)
While in the hospital, Medicare Part A will cover:
-Semi-private rooms
-Hospital services
-Supplies used in the hospital during the stay
-Nursing services
-Meals
Everyone that has Medicare Part A can be eligible for benefits when all the below mentioned conditions are true:
-Doctor’s order that states your need to stay in the hospital for treatment
-The care you need can be provided only by the hospital
-Hospital accepts Medicare insurance
-Your stay in the hospital is approved by the Utilization Review Committee.
The cost in traditional Medicare is $1,184(Your Medicare coverage. Hospital care inpatient. Medicare.Gov. The Official U.S Government Site for Medicare) deductible for each benefit period for hospital stay from 1-60 days, $296 coinsurance per day of each benefit period from day 61-90 and $592
SUBDOMAIN 734.3 - ORGANIZATIONAL SYSTEMS & QUALITY LEADERSHIP.
Competency 734.3.4: Healthcare Utilization and Finance
A1-Which costs will be covered by Medicare Part A?
Medicare Part A is otherwise called the Hospital Insurance and covers up to 100 days of the Skilled Nursing Facility stay. To be qualified for it the patient first has to have been hospitalized for more than 3 days in a hospital (qualifying hospital stay) so the stay in it would not be considered outpatient. After the hospital stay the doctor that followed the patient in the hospital or the PCP that releases the patient from the hospital needs to write the order for the SNF services. In order for a patient to receive the services from the SNF they have to:
-Have Medicare Part A insurance
-Have days left in the benefit period
-The SNF receiving the services from is Medicare certified
-Be in the SNF because of the need for daily skilled care which the SNF can provide
-Receive the services rendered daily even though sometimes offered 5-6 days only
-Have a condition that started during the stay in the SNF after being admitted for a hospital related medical condition (in this case stroke)
While in the hospital, Medicare Part A will cover:
-Semi-private rooms
-Hospital services
-Supplies used in the hospital during the stay
-Nursing services
-Meals
Everyone that has Medicare Part A can be eligible for benefits when all the below mentioned conditions are true:
-Doctor’s order that states your need to stay in the hospital for treatment
-The care you need can be provided only by the hospital
-Hospital accepts Medicare insurance
-Your stay in the hospital is approved by the Utilization Review Committee.
The cost in traditional Medicare is $1,184(Your Medicare coverage. Hospital care inpatient. Medicare.Gov. The Official U.S Government Site for Medicare) deductible for each benefit period for hospital stay from 1-60 days, $296 coinsurance per day of each benefit period from day 61-90 and $592