{"version":"https://jsonfeed.org/version/1","title":"Mastering Medicare","home_page_url":"https://www.masteringmedicare.net","feed_url":"https://www.masteringmedicare.net/json","description":"What's the difference between Home Health and Home Care? How do Medicare Part A and Part B work? How do you order DME for your patient? When and how should you order home oxygen? What's new in the eldercare space?\r\n\r\nFor physicians, other healthcare professionals, and senior-serving professionals, interacting with Medicare can be complicated and wrought with pitfalls, which, if not understood and managed, will mire your practice in endless paperwork and frustration.\r\n\r\nWe interview industry experts in every aspect of healthcare, from insurance companies, DME companies, home health agencies, medical providers, and many others, to bring you their real world expertise in the American healthcare system. \r\n\r\nYour hosts are Dr. Amy Schiffman and Dr. Alex Mohseni, two Emergency Medicine physicians who have branched off from traditional Emergency Medicine to explore and build solutions with a particular focus on eldercare and population health. \r\n\r\nJoin our Facebook group: https://www.facebook.com/groups/602747270479020/\r\n\r\nJoin our Subscriber List and get exclusive access to our Mastering Medicare Cheat Sheet and other goodies: https://www.masteringmedicare.net/subscribe","_fireside":{"subtitle":"Demystifying healthcare and Medicare for senior-serving professionals and providers. ","pubdate":"2023-09-12T12:00:00.000-04:00","explicit":false,"copyright":"2024 by Avicention LLC","owner":"Mastering Medicare","image":"https://assets.fireside.fm/file/fireside-images/podcasts/images/7/7ad1df9b-b658-4830-80a6-91982f00740a/cover.jpg?v=1"},"items":[{"id":"e84cded8-3f54-4ea8-be41-21e6261e815b","title":"Episode 24: E24: Networking is dead - Launch of AgingHere Slack group","url":"https://www.masteringmedicare.net/24","content_text":"\nUnconventional episode format: The hosts, Alex and the other speaker, interview each other.\n\"Networking is Dead\": The focus is on the importance of building meaningful relationships rather than traditional networking, especially in the senior and aging space.\nChallenges in the Senior Care Industry: Discusses the difficulties in breaking into the senior care market and the importance of building a Rolodex of contacts.\nCommunity Building: Introduces the concept of a Slack group aimed at connecting professionals in the senior care industry.\nValue Proposition: Emphasizes the importance of providing value to others in your network.\nSecurity Concerns: Briefly touches on the importance of data security, especially in healthcare.\nAccelerating Business Growth: The hosts express their desire to help listeners grow their businesses in the aging space, inviting feedback and participation.\n","content_html":"
Physicians and other senior-serving professionals trying to operate within the complicated Medicare ecosystem must be constantly learning, as the landscape, rules, tools, and vendors are in constant flux.
\nWe interview eldercare and Medicare industry experts, do deep dives into their companies, services, and experiences, and share their stories and insights with you.
Dr. Amy Schiffman and Dr. Alex Mohseni do a deep dive interview with Jonathan Edenbaum, the owner of Eden Homes about the ALF industry.
\nWhat is an Assisted Living
\nWhat is a Group Home
\nSmall vs large assisted living
\nKosher assisted living
\nKey triggers for transitioning from independent living to assisted living
\nStandard ratios in assisted living days vs nights
\nIncontinence as a trigger for assisted living
\nWhat patients don't qualify for ALFs
\nThey don't do ALFs, ventilators, certain bed sores (III or IV)
\nAssessments required for qualifying for ALF
\nRN needs to reevaluate the resident every 45 days
\nSome facilities charge more for level of care
\nRomantic relationships between ALF seniors
\nState and county unannounced random checks
\nHow to determine a low vs high quality ALF
\nDo an unannounced visit to check quality
\nGet family reference
\nRPM in the ALFs
\nZoning requirements for ALFs
\nHOA issues for ALFs
\nRisks in an ALF
\nMarketing ALF services
\nWhen an ALF resident gets hospitalized
\nEden Homes of Potomac
\nwww.edenhomesofpotomac.com
\n301-299-0090
\nJonathan recommends these finder services:
\nCarePatrol
\nFamilyTies
\nVideo version:
\nhttps://youtu.be/pJgIa3EWxVA
In this amazing interview with Robert Bullock, a DC-based Elder Law attorney, from The Elder & Disability Law Center, Dr. Amy Schiffman and Dr. Alex Mohseni discuss Medicaid Long Term Care coverage. We cover these topics:
\nWhat is Medicaid
\nMedica long term care eligibility
\nWhat does Medicaid waiver mean?
\nHow does one qualify for Medicaid
\nMedical eligibility for Medicaid long term care
\nFinancial eligibility for Medicaid long term care
\nMost people are in crisis mode when trying to qualify for Medicaid long term care
\nHow are patients assigned to rehab
\nMedicaid 5 year lookback
\nPut your assets into an irrevocable trust at least 5 years before you think you made need Medicaid
\nWhy doesn't Medicaid cover ALF
\nMedicaid long term care payments are like a loan
\nMedicaid estate recovery
\nAtlantic article on Medicaid estate recovery
\nLife care Planning and Management
\nAt what age should everybody talk to an elder law attorney
\nVideo version of this episode: https://youtu.be/EIwz0kv_O1o
Robert's contact information: 202-452-0000
\nhttps://www.edlc.com/
\non AVVO.com
Thank you to our sponsor:
\nThe RISE Virtual Medicare Marketing & Sales Summit taking February 19, 22-23, 2021, is offering 15% off with promo code POD15 to our listeners. To learn more about this event visit medicaremarketingsalessummit.com #RISEMMS2021
Danielle Doberman, MD, MPH, HMDC, is the Clinical Medical Director for Palliative Medicine at Johns Hopkins Hospital. Dr. Amy Schiffman and Dr. Alex Mohseni dive deep into the world of Palliative Care to understand what this commonly misunderstood specialty is all about. We cover the following:
\nWhat is palliative care / palliative medicine?
\nWhat symptoms does palliative focus on?
\nHow does palliative operate as a team?
\nHospital-based vs outpatient palliative care
\nPalliative care vs hospice
\nhttps://www.PrepareForYourCare.org
\nWho should be a palliative care patient?
\nWhere do most referrals to palliative care come from?
\nhttps://getpalliativecare.org
\nCenter to Advance Palliative Care www.capc.org
\nInteraction and relationship between PCPs and palliative care
\nContracting for safety and consent in palliative care
\nPalliative care pain management
\nPalliative Sedation (aka Proportional Sedation)
\nArticle: "Best Case Worst Case"
\nYoutube video "Best Case Worst Case"
\nPalliative care is not giving up
\nPalliative care services lose money but they help the hospital because they reduce inpatient length of stay
\n$3,000 of Part A savings per palliative care patient
\nTypical patient volumes for palliative care
\nYoutube version of this interview: https://youtu.be/poYoZ807SWU
Dr. Amy Schiffman and Dr. Alex Mohseni interview Steve Ackerman, the owner of Spectrum Medical, and do a deep dive into the world of Durable Medical Equipment (DME).
\nIntroduction to Steve Ackerman and Spectrum Medical
\nWhat is Durable Medical Equipment DME?
\nNot disposable, has to be able to sustain repeated use
\nCan't be used in the absence is disease or injury
\nCan't be an environment improvement
\nCan't be a safety item
\nControversy with DME beds
\nSemi-electric bed
\nPatients who need frequent immediate change in body position
\nDifferent types of DME wheelchairs
\nWhat is a seating clinic?
\nWhat are Assisted Device Professionals
\nChoices of wheelchairs
\nK codes for wheelchairs
\nHemi wheelchairs
\nK3 standard wheelchair is the most ordered wheelchair
\nParachute ordering portal
\nWalkers as DME
\nMedicare local coverage determination (LCD)
\nEvery equipment has its own LCD
\nClinical inference
\nSecondary market for DME
\n5-year limit
\nIndoor vs outdoor use of DME
\nWhat is a transport wheelchair?
\nFraud and abuse in DME
\nHow PT/OT help with getting DME
\nHoarders
\nDME company doesn't remove old equipment
\nImplications of having and MA plan for DME
\nRollators are not covered
\nWalkers vs Rollators
\nHow quickly can DME be delivered?
\nAging in place
\nVideo version: https://youtu.be/m9dM7PT63M0
Dr. Amy Schiffman and Dr. Alex Mohseni interview Michael Hughes, principal at Mitchell-Lowey, LLC, and do a deep dive into Medicare Advantage plans, especially as they relate to supplemental benefits like private duty home care services. We discuss:
\nWhat is Medicare Advantage
\nMA plans offer supplemental benefits
\nCMS is realizing that SDOH determine health and cost outcomes
\nWho costs the system the most
\nExamples of supplemental benefits include things like home care and pest control
\nHow many MA plans are there
\nSSBCI - special supplemental benefits for the chronically ill
\nHow does an MA plan measure effectiveness of supplemental benefits
\nHow do physicians order supplemental benefits for members
\nVBID model
\nConversion rate from MA plan to private pay
\nWhat are the downsides of choosing an MA plan
\nWhy MA plans care about the quality of supplemental benefits
\nMA plans as a percentage of total Medicare population by state (Link)
\nLink to Michael Hughes: https://www.linkedin.com/in/michael-hughes-7010221/
\nVideo version: https://www.youtube.com/watch?v=7NrtiqkkHtQ
In this episode we do a deep dive into Hospice with our guest, Cathy Gurson. She teaches us everything we ever wanted to know about Hospice. Here are some of the topics we cover:
\nHow do people get referred to hospice
\nHospice is covered 100% by Medicare part A
\nWhat does hospice cover
\nHow to get Part B medical care covered while under hospice
\nHospice reimbursement model
\nHospice per diem
\nThree levels of hospice care
\nPier diem changes at the higher levels of care
\nFor profit vs non-profit hospice
\nHospice certificate of need requirements
\nWhat questions you should ask about when interviewing a hospice
\nCHAP certification for hospice
\nTransitioning - what does transitioning mean in the context of hospice?
\nHow to know when a hospice patient is dying
\nDoes hospice pay for food and nutrition
\nTube feeding hospice patients
\nMeasuring mean arm circumference (MAC) as a measure of nutritional decline
\nWho is making the hospice recertification?
\nHospice patient’s relationships with their their PCP and hospice medical director
\nDNR status and resuscitating hospice patients
\nMost common reasons somebody leaves hospice status
\nWhat is the role of PCPs for patients in hospice status
\nWhat a PCP can bill for care plan oversight for a hospice patient
\nRetroactive hospice status changes
\nWhat happens if you don’t requalify for hospice recertification?
\nGraduating from hospice
\nVideo version: https://youtu.be/qat1HZicdrA
Dr. Amy Schiffman and Dr. Alex Mohseni do a deep dive into Alex's frustrations with documentation, billing, coding and his EMR in setting up a solo practice. They discuss the issues that make it nearly impossible for small practices to thrive if they agree to accept health insurance.
\nLink to Youtube video version: https://youtu.be/kI5QqVA9NAQ
Dr. Amy Schiffman and Dr. Alex Mohseni talk with the team from Fox Rehab about physical therapy, occupational therapy and speech pathology and uncover all the hidden issues, challenges, and secrets of this huge industry. If you are a senior-serving professional or medical provider who orders PT, OT or Speech services for your clients, you need to listen to this episode.
\nAlex and Amy cover the following topics:
\nSpeech Therapy vs Speech Language Pathologist
\nIn-home PT, OT and speech therapy for geriatric patients
\nPart A rehab vs Part B rehab
\nWhen and why do you flip from Part A therapy/rehab to Part B rehab?
\nHow do you continue to qualify for Part A therapy?
\nWho decides whether a patient has reached their therapy goal - the ordering provider or therapist?
\nWhat does a physical therapist do?
\nWhat does an occupational therapist do?
\nWhat does a speech therapist do?
\nPT vs OT vs Speech
\nFunctional independence
\nActivities of daily living
\nWhat does Medicare pay for with Part B PT, OT and Speech Therapy
\nTwo requirements for Medicare to pay for Part B rehab: medical necessity and skilled need
\nThe Therapy Cap for PT and Speech
\nPart B works on a calendar year basis
\nHow to get an exception to the Therapy Cap for PT, OT and Speech Pathology
\nCoding and billing PT, OT and SLP encounter CPT codes
\nWhat is a low-tech augmentative communication device?
\nWhat is the common work file in Medicare rehab?
\nHow often does a physical therapist usually go to a person's home?
\nWhat is the patient responsibility or copy for Medicare Part B rehab and physical therapy?
\nPart B rehab is not home health
\nWhich types of providers refer to Part B rehab the most?
\nMost common reasons for referral for Part B Rehab all revolve around falls: gait, balance, and weakness
\nDo not have to be homebound for Part B rehab in the home
\nCommon mistakes when referring to rehab
\nHow to write an order for PT, OT, or speech and what CPT codes to include
\nPart B rehab does medication reconciliation
\nHow to order DME
\nWhat is a 3-in-1 commode
\nHow long does it take to get a hospital bed paid for by Medicare
\nFoxRehab.org
With COVID-19 causing lots of seniors to be stuck at home and not be able to access the medical care that they need, Alex decides to start his own medical practice to serve this population. Alex chronicles everything he's doing to start this practice and gets Amy's help in figuring out lots of the details and issues. In this episode Alex and Amy discuss Medicare enrollment for individuals, organizations and employee providers, deploying Athenahealth EMR, and getting the first patients. Alex's Medicare telemedicine practice is called Canary Doctor.
\nDr. Alex Mohseni and Dr. Amy Schiffman are two Emergency Medicine doctors who are the hosts of MasteringMedicare.net, a podcast helping unearth the secrets of Medicare for healthcare providers and senior-serving professionals.
\nVideo version of episode: https://youtu.be/MeRWrKF6eno
Part 2 of our incredible interview with Andy Diamond, the President of Diamond Medical Labs and Mobile Medical Imaging. In this amazing episode, Andy teaches us everything about how mobile medical imaging is done in nursing homes, rehabs, assisted livings and in patients' homes.
\nIn part 2 we discuss:
\nBrief summary of mobile labs episode
\nWhat sort of equipment do mobile medical imaging labs have in their cars?
\nHow do you get mobile imaging equipment up a flight of stairs?
\nHow much does a mobile digital x-ray machine cost?
\nHow quickly can you get imaging done in a patient's home?
\nThe logistics challenges of home-based medical care
\nManaging dispatchers for home-based services
\nHow is the logistics of labs more complicated than radiology?
\nIs there a transportation fee for radiology done in the home?
\nHow do trip fees work when visiting an assisted living or nursing home?
\nHow do you split the trip fee?
\nWhat technology is used to manage logistics for home-based care?
\nLab tests are not subject to Medicare deductible but imaging is
\nWhat could providers do better when ordering labs and radiology?
\nTraining nursing home staff on anatomy
\nPoint Click Care
\nNo trip fee on EKG and ultrasound; trip fee only on x-rays
\nDo lab and radiology providers need to get patient consent when they visit a nursing home or assisted living?
\nWhat is the minimum percent of tests a lab must do in-house?
\nHow many patients per day can a mobile radiology tech perform?
\nHow quickly do labs need to be run?
With COVID-19 causing lots of seniors to be stuck at home and not be able to access the medical care that they need, Alex decides to start his own medical practice to serve this population. Alex chronicles everything he's doing to start this practice and gets Amy's help in figuring out lots of the details and issues. Alex and Amy discuss Medicare enrollment for individuals, organizations and employee providers, choosing an EMR, choosing a telemedicine platform, setting up medical malpractice insurance, planning for NPs and PAs, rules for supervision of NPs and PAs, reimbursement models, and how to figure out how much you are going to get paid.
\nDr. Alex Mohseni and Dr. Amy Schiffman are two Emergency Medicine doctors who are the hosts of MasteringMedicare.net, a podcast helping unearth the secrets of Medicare for healthcare providers and senior-serving professionals.
\nVideo version of episode: https://youtu.be/ebZZkHHBy30
Amy and Alex interview Andy Diamond, the President of Diamond Medical Labs and Mobile Medical Imaging. In this amazing episode, Andy teaches us everything about how labs are done in nursing homes, rehabs, assisted livings and in patients' homes.
\nIn part 1 we discuss:
\nHow and why do lab companies have contracts with nursing homes and assisted living facilities?
\nPart A and Part B billing for labs in the same facility
\nFiguring out Same and Similar in the lab world
\nPatient financial responsibility for labs drawn in a nursing home
\nLack of centralized database of lab data
\nIntegration with state health information exchange / CRISP
\nWhat is a health information exchange?
\nWhy does CRISP charge the lab company to participate?
\nNursing home is paying for some lab tests directly
\nLab billing denials
\nRevenue cycle management in the lab world
\nWhat are the most common mistakes and issues when nursing homes and assisted livings order labs?
\nWhat labs aren't allowed to tell ordering physicians?
\nAlex thinks the rules for ordering labs are stupid
\nTrends in lab testing
\nMolecular testing - why is molecular testing becoming more popular?
\nWho collects urine samples in nursing homes and homebound patients?
\nWhat is the cost of molecular testing and is the denial rate different?
\nWhat things to consider other than just the cost of a lab test?
\nWorkflow requirements for molecular testing
\nPGX testing - what is it and why would you order it?
\nCost of PGX testing
\nAre the results from PGX testing easy to interpret?
\nEffect of PAMA on labs and lookback for lab payments
\nWhy doctors can't have their own labs
Amy and Alex interview Dr. Howard Haft, the Executive Director of the Maryland Primary Care Program, and Tammy Liu, a Primary Care Transformation Coach. We do a deep dive into the Maryland Primary Care Program and understand how this amazing innovative program is helping physicians provide higher quality more holistic care while providing physicians the tools and resources they need to provide that care in an efficient and low-friction way.
\n\nWe discuss so many valuable topics in this episode:
\nWho is Dr. Howard Haft
\nWhat is the Maryland Primary Care Program
\nMaryland All Payer Model
\nGlobal Budget Revenue Hospital Payment Model
\nWhat do Primary Care Practice Transformation Coaches do
\nAdvanced Alternative Payment Model
\nTrack 1
\nTrack 2
\nUpfront payments
\nIs the Maryland Primary Care Program only for Medicare
\nCarefirst participation in the Maryland Primary Care Program
\nHow much extra can physicians earn from the Maryland Primary Care Program
\nAverage $40,000 per year per physician
\nCare Transformation Organizations
\nAdministrative requirements of the Primary Care Program
\nECQMs
\nAlex's mind gets blown
\nEmpathy in healthcare
\n20% Reduction in avoidable admissions
\nPredicting high risk patients and avoidable admissions
\nHow Maryland is using machine learning to support primary care doctors
\nSocial Determinants of Health services in Maryland
\nHow to order SDOH services from CRISP
\nHow community-based organizations can work with the Maryland Primary Care Program
\n211 service in Maryland
\nGlobal Budget contracts
\nMaryland Stakeholder Innovation Group
Alex and Amy discuss telemedicine and RPM (remote patient monitoring) in the COVID-19 Era. Medicare has published new rules for telemedicine to help cope with the novel coronavirus epidemic. Medicare also published new rules for RPM that went live Jan 1 of 2020. These rules create valuable opportunities for medical providers, especially with COVID-19 quarantine and isolation requirements.
\nWe discuss:
\nappreciation for our emergency medicine colleagues
\noriginal medicare telemedicine telemedicine requirements
\nMedicare telemedicine geography requirement
\nMedicare telemedicine originating site requirement
\nCOVID19 Medicare telemedicine reimbursement updates
\nHHS won't audit preexisting relationship rule, but what about MACs?
\nProvider licensure requirements for telemedicine
\nFee for service telemedicine billing guide
\nHome health telemedicine
\nRPM (Remote Patient Monitoring) COVID19
\nConnection between real estate tax code and healthcare opportunities
\nWhy is Medicare paying for RPM
\nHow does remote monitoring work
\nAlex's Concierge Medicine RPM article
\nHow much does RPM pay
\nMedicare eVisit non-face-to-face encounters
\nRole of RPM with addressing loneliness in seniors
\nSome states' Medicaid programs pay for RPM
\nKudos to Dr. Blake McKinney from CirrusMD
\nTelemedicine pictures need to be treated like radiology films
\nAccuhealth RPM website
\nEmail us at amy@masteringmedicare.net or alex@masteringmedicare.net for our RPM Workbook
Alex and Amy discuss the urgent need during this COVID-19 pandemic for folks to think about difficult end-of-life deicisions and they walk the audience through the details of filling out the MOLST form.
\nMOLST: Medical Orders for Life-Sustaining Treatment
\nPOLST: Physician's Orders for Life-Sustaining Treatment
\nIn this episode, we discuss:
\nWhat is a MOLST form
\nWhat is a POLST form
\nWhy should we talk about end of life care
\nCoronavirus / COVID-19 concerns
\nWhen should you fill out a MOLST form?
\nWho should fill out a MOLST form?
\nCan you make copies of a MOLST form?
\nWhere should you keep your MOLST form?
\nWhat is CPR?
\nWhat is intubation?
\nMOLST form options
In this Mastering Medicare episode, Dr. Amy Schiffman and Dr. Alex Mohseni do a moderate dive into Medicare Part D. We discuss the following topics:
\n\nWhat is Part D Medicare
\nOpt in Part D
\nPremium calculation for Medicare Part D
\nWhat is the Medicare Donut Hole?
\nMedicare Part D Donut Hole
\n4 stages of Part D
\nPart D deductible stage: first $435
\nPart D initial coverage stage: first $4,020, up to 25% of cost of medication
\nTiers of medications in Part D
\nPart D tier 1 medications
\nPart D stage 3: donut hole, 25% patient responsibility
\nPart D stage 4: catastrophic stage, copay
Visit Mastering Medicare at MasteringMedicare.NET
","summary":"Mastering Medicare is a podcast helping demystify healthcare and Medicare for senior-serving professionals and providers. ","date_published":"2020-03-10T14:00:00.000-04:00","attachments":[{"url":"https://aphid.fireside.fm/d/1437767933/7ad1df9b-b658-4830-80a6-91982f00740a/16de9237-3312-4017-b302-9195abd6f851.mp3","mime_type":"audio/mp3","size_in_bytes":11438856,"duration_in_seconds":953}]},{"id":"0b53d4f0-8427-4aff-948f-7f8ce5891ead","title":"Episode 3: Medicare Part B","url":"https://www.masteringmedicare.net/3","content_text":"Physicians and other senior-serving professionals trying to operate within the complicated Medicare ecosystem must be constantly learning, as the landscape, rules, tools, and vendors are in constant flux. \nWe interview eldercare and Medicare industry experts, do deep dives into their companies, services, and experiences, and share their stories and insights with you. \n\nHere are some of the topics that we cover:\n\nWhat is Medicare Part B\nWhat services are included in Part B\nProfessional services\nPart B Physical Therapy\nPart B Outpatient Labs\nPart B Outpatient Radiology\nDoes Medicare pay for DME\nWhen does Medicare pay for 911\nMedicare Part B is opt in\nHow much does Medicare Part B cost\nMedicare Part B monthly premium\nMedicare covers part only 80%\nMedicare secondary insurance / Medigap / supplemental\nPart A vs Part B Physical Therapy\nCost sharing for radiology\nCost sharing for lab tests under Medicare\nMedicare limits on lab tests\nDME\nHow do you order DME, wheelchair, hospital bed in a patient's home\n13 month lease to own DME\nSame and similar DME\nParachute same and similar DME","content_html":"Physicians and other senior-serving professionals trying to operate within the complicated Medicare ecosystem must be constantly learning, as the landscape, rules, tools, and vendors are in constant flux.
\nWe interview eldercare and Medicare industry experts, do deep dives into their companies, services, and experiences, and share their stories and insights with you.
Here are some of the topics that we cover:
\n\nWhat is Medicare Part B
\nWhat services are included in Part B
\nProfessional services
\nPart B Physical Therapy
\nPart B Outpatient Labs
\nPart B Outpatient Radiology
\nDoes Medicare pay for DME
\nWhen does Medicare pay for 911
\nMedicare Part B is opt in
\nHow much does Medicare Part B cost
\nMedicare Part B monthly premium
\nMedicare covers part only 80%
\nMedicare secondary insurance / Medigap / supplemental
\nPart A vs Part B Physical Therapy
\nCost sharing for radiology
\nCost sharing for lab tests under Medicare
\nMedicare limits on lab tests
\nDME
\nHow do you order DME, wheelchair, hospital bed in a patient's home
\n13 month lease to own DME
\nSame and similar DME
\nParachute same and similar DME
Physicians and other senior-serving professionals trying to operate within the complicated Medicare ecosystem must be constantly learning, as the landscape, rules, tools, and vendors are in constant flux.
\nWe interview eldercare and Medicare industry experts, do deep dives into their companies, services, and experiences, and share their stories and insights with you.
In this Mastering Medicare episode, we cover:
\nHow you qualify for Medicare
\nQualifying for Medicare via ALS
\nQualifying for Medicare via ESRD on dialysis
\nQualifying for Medicare via SSDI disability
\nMedicare and VA insurance
\nHistory of Medicare
\nInpatient hospitalization
\nRehab aka SNF aka nursing home
\nHome health
\nHospice
\nMedicare copays and cost sharing for hospitalization
\nMedicare part A annual deductible
\nMedicare cost sharing with rehab SNF
\nMedicare part A home health
\nWhat is Home health?
\nHome health 485 form
\nWhat is skilled nursing?
\nWhat does part A PT/OT do?
\nCopay for part A PT OT
\nHome health "taxing effort"
\nCertification of being homebound home health
\nCertification periods for home health
\nRecertification of medicare part A home health
\nHome health aides
\nHome health 45 minutes twice per week
\nWill Medicare pay for wound care supplies?
\nMedicare hospice
\nWhat is hospice
\nWill Medicare pay for hospice
\nQualifying for hospice
\nHospice certification periods
\nWhat does hospice cover and pay for
\nHospice payment model
\nWho pays for a hospice patient if they go to the ER?
\nHospice is a risk bearing entity
\nHospice certification and recertification periods
\nWhat does it mean to be admitted to a hospital
Physicians and other senior-serving professionals trying to operate within the complicated Medicare ecosystem must be constantly learning, as the landscape, rules, tools, and vendors are in constant flux.
\nWe interview eldercare and Medicare industry experts, do deep dives into their companies, services, and experiences, and share their stories and insights with you.
\nBrought to you by two passionate but critical physicians who broke away from the conventional career paths of their specialty.
In this episode we cover:
\nDr. Amy Schiffman and Dr. Alex Mohseni introduce themselves
\nMedicare overview
\nPart A overview, including cost sharing
\nPart A: Hospital, Rehab, Home Health, Hospice
\nPart B overview
\nPart B 80/20 split, Medigap / supplemental
\nPart D
\nInpatient vs outpatient medications
\nInpatient vs outpatient status
\nObservation status
\nPart C - Medicare Advantage
Join our Subscriber List to get your copy of our Medicare Cheat Sheet
\nhttps://www.masteringmedicare.net/subscribe