web02.fireside.fm Sun, 14 Jun 2026 16:05:11 -0500 Fireside (https://fireside.fm) https://www.masteringmedicare.net/tags/health Mon, 12 Oct 2020 06:00:00 -0400 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? For 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. We 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. Your 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. Join our Facebook group: https://www.facebook.com/groups/602747270479020/ Join our Subscriber List and get exclusive access to our Mastering Medicare Cheat Sheet and other goodies: https://www.masteringmedicare.net/subscribe en-us episodic Demystifying healthcare and Medicare for senior-serving professionals and providers. Mastering Medicare 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? For 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. We 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. Your 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. Join our Facebook group: https://www.facebook.com/groups/602747270479020/ Join our Subscriber List and get exclusive access to our Mastering Medicare Cheat Sheet and other goodies: https://www.masteringmedicare.net/subscribe no elder care, eldercare, Medicare, Medicaid, healthcare, senior care, senior, seniors, senior-serving professionals, medical care, insurance company Mastering Medicare alex@masteringmedicare.net https://www.masteringmedicare.net/15 141c7ce5-c8f3-4acf-a981-3ca94fc1a458 Mon, 12 Oct 2020 06:00:00 -0400 Mastering Medicare full Mastering Medicare Mastering Medicare is a podcast helping demystify healthcare and Medicare for senior-serving professionals and providers. 1:04:51 no <p>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:<br> What is Medicare Advantage<br> MA plans offer supplemental benefits<br> CMS is realizing that SDOH determine health and cost outcomes<br> Who costs the system the most<br> Examples of supplemental benefits include things like home care and pest control<br> How many MA plans are there<br> SSBCI - special supplemental benefits for the chronically ill<br> How does an MA plan measure effectiveness of supplemental benefits<br> How do physicians order supplemental benefits for members<br> VBID model<br> Conversion rate from MA plan to private pay<br> What are the downsides of choosing an MA plan<br> Why MA plans care about the quality of supplemental benefits<br> MA plans as a percentage of total Medicare population by state (<a href="https://www.kff.org/medicare/state-indicator/enrollees-as-a-of-total-medicare-population/?activeTab=map&amp;currentTimeframe=0&amp;selectedDistributions=overall&amp;sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D" rel="nofollow noopener">Link</a>)<br> Link to Michael Hughes: <a href="https://www.linkedin.com/in/michael-hughes-7010221/" rel="nofollow noopener">https://www.linkedin.com/in/michael-hughes-7010221/</a><br> Video version: <a href="https://www.youtube.com/watch?v=7NrtiqkkHtQ" rel="nofollow noopener">https://www.youtube.com/watch?v=7NrtiqkkHtQ</a> </p> Medicare, healthcare, physician, medical, senior care, eldercare, elder care, elder, seniors, medicare advantage, home care, private duty 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:
What is Medicare Advantage
MA plans offer supplemental benefits
CMS is realizing that SDOH determine health and cost outcomes
Who costs the system the most
Examples of supplemental benefits include things like home care and pest control
How many MA plans are there
SSBCI - special supplemental benefits for the chronically ill
How does an MA plan measure effectiveness of supplemental benefits
How do physicians order supplemental benefits for members
VBID model
Conversion rate from MA plan to private pay
What are the downsides of choosing an MA plan
Why MA plans care about the quality of supplemental benefits
MA plans as a percentage of total Medicare population by state (Link)
Link to Michael Hughes: https://www.linkedin.com/in/michael-hughes-7010221/
Video version: https://www.youtube.com/watch?v=7NrtiqkkHtQ

]]> 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:
What is Medicare Advantage
MA plans offer supplemental benefits
CMS is realizing that SDOH determine health and cost outcomes
Who costs the system the most
Examples of supplemental benefits include things like home care and pest control
How many MA plans are there
SSBCI - special supplemental benefits for the chronically ill
How does an MA plan measure effectiveness of supplemental benefits
How do physicians order supplemental benefits for members
VBID model
Conversion rate from MA plan to private pay
What are the downsides of choosing an MA plan
Why MA plans care about the quality of supplemental benefits
MA plans as a percentage of total Medicare population by state (Link)
Link to Michael Hughes: https://www.linkedin.com/in/michael-hughes-7010221/
Video version: https://www.youtube.com/watch?v=7NrtiqkkHtQ

]]> https://www.masteringmedicare.net/14 6ae3508f-565d-4423-8c45-960ba761fac1 Fri, 11 Sep 2020 06:00:00 -0400 Mastering Medicare full Mastering Medicare Mastering Medicare is a podcast helping demystify healthcare and Medicare for senior-serving professionals and providers. 1:23:38 no <p>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:<br> How do people get referred to hospice<br> Hospice is covered 100% by Medicare part A<br> What does hospice cover<br> How to get Part B medical care covered while under hospice<br> Hospice reimbursement model<br> Hospice per diem<br> Three levels of hospice care<br> Pier diem changes at the higher levels of care<br> For profit vs non-profit hospice<br> Hospice certificate of need requirements<br> What questions you should ask about when interviewing a hospice<br> CHAP certification for hospice<br> Transitioning - what does transitioning mean in the context of hospice?<br> How to know when a hospice patient is dying<br> Does hospice pay for food and nutrition<br> Tube feeding hospice patients<br> Measuring mean arm circumference (MAC) as a measure of nutritional decline<br> Who is making the hospice recertification?<br> Hospice patient’s relationships with their their PCP and hospice medical director<br> DNR status and resuscitating hospice patients<br> Most common reasons somebody leaves hospice status<br> What is the role of PCPs for patients in hospice status<br> What a PCP can bill for care plan oversight for a hospice patient<br> Retroactive hospice status changes<br> What happens if you don’t requalify for hospice recertification?<br> Graduating from hospice<br> Video version: <a href="https://youtu.be/qat1HZicdrA" rel="nofollow noopener">https://youtu.be/qat1HZicdrA</a> </p> Medicare, healthcare, physician, medical, senior care, eldercare, elder care, elder, seniors, hospice, hospice care, palliative care 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:
How do people get referred to hospice
Hospice is covered 100% by Medicare part A
What does hospice cover
How to get Part B medical care covered while under hospice
Hospice reimbursement model
Hospice per diem
Three levels of hospice care
Pier diem changes at the higher levels of care
For profit vs non-profit hospice
Hospice certificate of need requirements
What questions you should ask about when interviewing a hospice
CHAP certification for hospice
Transitioning - what does transitioning mean in the context of hospice?
How to know when a hospice patient is dying
Does hospice pay for food and nutrition
Tube feeding hospice patients
Measuring mean arm circumference (MAC) as a measure of nutritional decline
Who is making the hospice recertification?
Hospice patient’s relationships with their their PCP and hospice medical director
DNR status and resuscitating hospice patients
Most common reasons somebody leaves hospice status
What is the role of PCPs for patients in hospice status
What a PCP can bill for care plan oversight for a hospice patient
Retroactive hospice status changes
What happens if you don’t requalify for hospice recertification?
Graduating from hospice
Video version: https://youtu.be/qat1HZicdrA

]]> 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:
How do people get referred to hospice
Hospice is covered 100% by Medicare part A
What does hospice cover
How to get Part B medical care covered while under hospice
Hospice reimbursement model
Hospice per diem
Three levels of hospice care
Pier diem changes at the higher levels of care
For profit vs non-profit hospice
Hospice certificate of need requirements
What questions you should ask about when interviewing a hospice
CHAP certification for hospice
Transitioning - what does transitioning mean in the context of hospice?
How to know when a hospice patient is dying
Does hospice pay for food and nutrition
Tube feeding hospice patients
Measuring mean arm circumference (MAC) as a measure of nutritional decline
Who is making the hospice recertification?
Hospice patient’s relationships with their their PCP and hospice medical director
DNR status and resuscitating hospice patients
Most common reasons somebody leaves hospice status
What is the role of PCPs for patients in hospice status
What a PCP can bill for care plan oversight for a hospice patient
Retroactive hospice status changes
What happens if you don’t requalify for hospice recertification?
Graduating from hospice
Video version: https://youtu.be/qat1HZicdrA

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