web02.fireside.fm Fri, 01 May 2026 01:12:39 -0500 Fireside (https://fireside.fm) Mastering Medicare - Episodes Tagged with “Healthcare” https://www.masteringmedicare.net/tags/healthcare Thu, 04 Feb 2021 08:00:00 -0500 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 Episode 18: Medicaid Long Term Care: interview with Robert Bullock Esq., The Elder & Disability Law Center https://www.masteringmedicare.net/18 02a3f72d-dd11-4227-bab9-4d21733981d0 Thu, 04 Feb 2021 08:00:00 -0500 Mastering Medicare full Mastering Medicare Mastering Medicare is a podcast helping demystify healthcare and Medicare for senior-serving professionals and providers. 1:06:09 no In this amazing interview with Robert Bullock, a DC-based Elder Law attorney, from The Elder & Disability Law Center (https://www.edlc.com/), Dr. Amy Schiffman and Dr. Alex Mohseni discuss Medicaid Long Term Care coverage. We cover these topics: What is Medicaid Medica long term care eligibility What does Medicaid waiver mean? How does one qualify for Medicaid Medical eligibility for Medicaid long term care Financial eligibility for Medicaid long term care Most people are in crisis mode when trying to qualify for Medicaid long term care How are patients assigned to rehab Medicaid 5 year lookback Put your assets into an irrevocable trust at least 5 years before you think you made need Medicaid Why doesn't Medicaid cover ALF Medicaid long term care payments are like a loan Medicaid estate recovery Atlantic article on Medicaid estate recovery (https://www.theatlantic.com/magazine/archive/2019/10/when-medicaid-takes-everything-you-own/596671/) Life care Planning and Management At what age should everybody talk to an elder law attorney Video version of this episode: https://youtu.be/EIwz0kv_O1o Robert's contact information: 202-452-0000 https://www.edlc.com/ on AVVO.com (https://www.avvo.com/attorneys/20036-dc-robert-bullock-672970.html) Thank you to our sponsor: The 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 (https://www.medicaremarketingsalessummit.com/) #RISEMMS2021 Medicare, healthcare, physician, medical, senior care, eldercare, elder care, elder, seniors, Medicaid, estate recovery, estate planning 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:
What is Medicaid
Medica long term care eligibility
What does Medicaid waiver mean?
How does one qualify for Medicaid
Medical eligibility for Medicaid long term care
Financial eligibility for Medicaid long term care
Most people are in crisis mode when trying to qualify for Medicaid long term care
How are patients assigned to rehab
Medicaid 5 year lookback
Put your assets into an irrevocable trust at least 5 years before you think you made need Medicaid
Why doesn't Medicaid cover ALF
Medicaid long term care payments are like a loan
Medicaid estate recovery
Atlantic article on Medicaid estate recovery
Life care Planning and Management
At what age should everybody talk to an elder law attorney
Video version of this episode: https://youtu.be/EIwz0kv_O1o

Robert's contact information: 202-452-0000
https://www.edlc.com/
on AVVO.com

Thank you to our sponsor:
The 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

]]> 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:
What is Medicaid
Medica long term care eligibility
What does Medicaid waiver mean?
How does one qualify for Medicaid
Medical eligibility for Medicaid long term care
Financial eligibility for Medicaid long term care
Most people are in crisis mode when trying to qualify for Medicaid long term care
How are patients assigned to rehab
Medicaid 5 year lookback
Put your assets into an irrevocable trust at least 5 years before you think you made need Medicaid
Why doesn't Medicaid cover ALF
Medicaid long term care payments are like a loan
Medicaid estate recovery
Atlantic article on Medicaid estate recovery
Life care Planning and Management
At what age should everybody talk to an elder law attorney
Video version of this episode: https://youtu.be/EIwz0kv_O1o

Robert's contact information: 202-452-0000
https://www.edlc.com/
on AVVO.com

Thank you to our sponsor:
The 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

]]> Episode 16: DME Durable Medical Equipment - interview with Steve Ackerman https://www.masteringmedicare.net/16 59d890fd-a27d-4a60-9a1c-6d2928ce4f7e Mon, 19 Oct 2020 18:00:00 -0400 Mastering Medicare full Mastering Medicare Mastering Medicare is a podcast helping demystify healthcare and Medicare for senior-serving professionals and providers. 1:08:00 no 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). Introduction to Steve Ackerman and Spectrum Medical (https://www.spectrummedical.net/) What is Durable Medical Equipment DME? Not disposable, has to be able to sustain repeated use Can't be used in the absence is disease or injury Can't be an environment improvement Can't be a safety item Controversy with DME beds Semi-electric bed Patients who need frequent immediate change in body position Different types of DME wheelchairs What is a seating clinic? What are Assisted Device Professionals Choices of wheelchairs K codes for wheelchairs Hemi wheelchairs K3 standard wheelchair is the most ordered wheelchair Parachute ordering portal Walkers as DME Medicare local coverage determination (LCD) Every equipment has its own LCD Clinical inference Secondary market for DME 5-year limit Indoor vs outdoor use of DME What is a transport wheelchair? Fraud and abuse in DME How PT/OT help with getting DME Hoarders DME company doesn't remove old equipment Implications of having and MA plan for DME Rollators are not covered Walkers vs Rollators How quickly can DME be delivered? Aging in place Video version: https://youtu.be/m9dM7PT63M0 Medicare, healthcare, physician, medical, senior care, eldercare, elder care, elder, seniors, dme, durable medical equipment 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).
Introduction to Steve Ackerman and Spectrum Medical
What is Durable Medical Equipment DME?
Not disposable, has to be able to sustain repeated use
Can't be used in the absence is disease or injury
Can't be an environment improvement
Can't be a safety item
Controversy with DME beds
Semi-electric bed
Patients who need frequent immediate change in body position
Different types of DME wheelchairs
What is a seating clinic?
What are Assisted Device Professionals
Choices of wheelchairs
K codes for wheelchairs
Hemi wheelchairs
K3 standard wheelchair is the most ordered wheelchair
Parachute ordering portal
Walkers as DME
Medicare local coverage determination (LCD)
Every equipment has its own LCD
Clinical inference
Secondary market for DME
5-year limit
Indoor vs outdoor use of DME
What is a transport wheelchair?
Fraud and abuse in DME
How PT/OT help with getting DME
Hoarders
DME company doesn't remove old equipment
Implications of having and MA plan for DME
Rollators are not covered
Walkers vs Rollators
How quickly can DME be delivered?
Aging in place
Video version: https://youtu.be/m9dM7PT63M0

]]> 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).
Introduction to Steve Ackerman and Spectrum Medical
What is Durable Medical Equipment DME?
Not disposable, has to be able to sustain repeated use
Can't be used in the absence is disease or injury
Can't be an environment improvement
Can't be a safety item
Controversy with DME beds
Semi-electric bed
Patients who need frequent immediate change in body position
Different types of DME wheelchairs
What is a seating clinic?
What are Assisted Device Professionals
Choices of wheelchairs
K codes for wheelchairs
Hemi wheelchairs
K3 standard wheelchair is the most ordered wheelchair
Parachute ordering portal
Walkers as DME
Medicare local coverage determination (LCD)
Every equipment has its own LCD
Clinical inference
Secondary market for DME
5-year limit
Indoor vs outdoor use of DME
What is a transport wheelchair?
Fraud and abuse in DME
How PT/OT help with getting DME
Hoarders
DME company doesn't remove old equipment
Implications of having and MA plan for DME
Rollators are not covered
Walkers vs Rollators
How quickly can DME be delivered?
Aging in place
Video version: https://youtu.be/m9dM7PT63M0

]]> Episode 15: Medicare Advantage (MA plans) - a deep dive with Michael Hughes 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 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 (https://www.kff.org/medicare/state-indicator/enrollees-as-a-of-total-medicare-population/?activeTab=map¤tTimeframe=0&selectedDistributions=overall&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D)) Link to Michael Hughes: https://www.linkedin.com/in/michael-hughes-7010221/ Video version: https://www.youtube.com/watch?v=7NrtiqkkHtQ 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

]]> Episode 14: Hospice and Secrets of the Hospice Industry 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 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 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

]]> Episode 12: Everything you ever wanted to know about PT, OT, and Speech Pathology https://www.masteringmedicare.net/12 149b2aca-5a4d-4aa0-91ad-653e06816362 Wed, 24 Jun 2020 07:00:00 -0400 Mastering Medicare full Mastering Medicare Mastering Medicare is a podcast helping demystify healthcare and Medicare for senior-serving professionals and providers. 1:28:45 no Dr. Amy Schiffman and Dr. Alex Mohseni talk with the team from Fox Rehab (https://www.foxrehab.org/) 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. Alex and Amy cover the following topics: Speech Therapy vs Speech Language Pathologist In-home PT, OT and speech therapy for geriatric patients Part A rehab vs Part B rehab When and why do you flip from Part A therapy/rehab to Part B rehab? How do you continue to qualify for Part A therapy? Who decides whether a patient has reached their therapy goal - the ordering provider or therapist? What does a physical therapist do? What does an occupational therapist do? What does a speech therapist do? PT vs OT vs Speech Functional independence Activities of daily living What does Medicare pay for with Part B PT, OT and Speech Therapy Two requirements for Medicare to pay for Part B rehab: medical necessity and skilled need The Therapy Cap for PT and Speech Part B works on a calendar year basis How to get an exception to the Therapy Cap for PT, OT and Speech Pathology Coding and billing PT, OT and SLP encounter CPT codes What is a low-tech augmentative communication device? What is the common work file in Medicare rehab? How often does a physical therapist usually go to a person's home? What is the patient responsibility or copy for Medicare Part B rehab and physical therapy? Part B rehab is not home health Which types of providers refer to Part B rehab the most? Most common reasons for referral for Part B Rehab all revolve around falls: gait, balance, and weakness Do not have to be homebound for Part B rehab in the home Common mistakes when referring to rehab How to write an order for PT, OT, or speech and what CPT codes to include Part B rehab does medication reconciliation How to order DME What is a 3-in-1 commode How long does it take to get a hospital bed paid for by Medicare FoxRehab.org Medicare, healthcare, physician, medical, senior care, eldercare, elder care, elder, seniors, PT, OT, Speech, physical therapy, occupational therapy, speech pathology, rehab 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.
Alex and Amy cover the following topics:
Speech Therapy vs Speech Language Pathologist
In-home PT, OT and speech therapy for geriatric patients
Part A rehab vs Part B rehab
When and why do you flip from Part A therapy/rehab to Part B rehab?
How do you continue to qualify for Part A therapy?
Who decides whether a patient has reached their therapy goal - the ordering provider or therapist?
What does a physical therapist do?
What does an occupational therapist do?
What does a speech therapist do?
PT vs OT vs Speech
Functional independence
Activities of daily living
What does Medicare pay for with Part B PT, OT and Speech Therapy
Two requirements for Medicare to pay for Part B rehab: medical necessity and skilled need
The Therapy Cap for PT and Speech
Part B works on a calendar year basis
How to get an exception to the Therapy Cap for PT, OT and Speech Pathology
Coding and billing PT, OT and SLP encounter CPT codes
What is a low-tech augmentative communication device?
What is the common work file in Medicare rehab?
How often does a physical therapist usually go to a person's home?
What is the patient responsibility or copy for Medicare Part B rehab and physical therapy?
Part B rehab is not home health
Which types of providers refer to Part B rehab the most?
Most common reasons for referral for Part B Rehab all revolve around falls: gait, balance, and weakness
Do not have to be homebound for Part B rehab in the home
Common mistakes when referring to rehab
How to write an order for PT, OT, or speech and what CPT codes to include
Part B rehab does medication reconciliation
How to order DME
What is a 3-in-1 commode
How long does it take to get a hospital bed paid for by Medicare
FoxRehab.org

]]> 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.
Alex and Amy cover the following topics:
Speech Therapy vs Speech Language Pathologist
In-home PT, OT and speech therapy for geriatric patients
Part A rehab vs Part B rehab
When and why do you flip from Part A therapy/rehab to Part B rehab?
How do you continue to qualify for Part A therapy?
Who decides whether a patient has reached their therapy goal - the ordering provider or therapist?
What does a physical therapist do?
What does an occupational therapist do?
What does a speech therapist do?
PT vs OT vs Speech
Functional independence
Activities of daily living
What does Medicare pay for with Part B PT, OT and Speech Therapy
Two requirements for Medicare to pay for Part B rehab: medical necessity and skilled need
The Therapy Cap for PT and Speech
Part B works on a calendar year basis
How to get an exception to the Therapy Cap for PT, OT and Speech Pathology
Coding and billing PT, OT and SLP encounter CPT codes
What is a low-tech augmentative communication device?
What is the common work file in Medicare rehab?
How often does a physical therapist usually go to a person's home?
What is the patient responsibility or copy for Medicare Part B rehab and physical therapy?
Part B rehab is not home health
Which types of providers refer to Part B rehab the most?
Most common reasons for referral for Part B Rehab all revolve around falls: gait, balance, and weakness
Do not have to be homebound for Part B rehab in the home
Common mistakes when referring to rehab
How to write an order for PT, OT, or speech and what CPT codes to include
Part B rehab does medication reconciliation
How to order DME
What is a 3-in-1 commode
How long does it take to get a hospital bed paid for by Medicare
FoxRehab.org

]]> Episode 4: Medicare Part D https://www.masteringmedicare.net/4 16de9237-3312-4017-b302-9195abd6f851 Tue, 10 Mar 2020 14:00:00 -0400 Mastering Medicare full Mastering Medicare Mastering Medicare is a podcast helping demystify healthcare and Medicare for senior-serving professionals and providers. 15:53 no 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: What is Part D Medicare Opt in Part D Premium calculation for Medicare Part D What is the Medicare Donut Hole? Medicare Part D Donut Hole 4 stages of Part D Part D deductible stage: first $435 Part D initial coverage stage: first $4,020, up to 25% of cost of medication Tiers of medications in Part D Part D tier 1 medications Part D stage 3: donut hole, 25% patient responsibility Part D stage 4: catastrophic stage, copay Visit Mastering Medicare at MasteringMedicare.NET (https://www.masteringmedicare.net/) Medicare, healthcare, physician, medical, senior care, eldercare, elder care, elder, seniors, part d 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:

What is Part D Medicare
Opt in Part D
Premium calculation for Medicare Part D
What is the Medicare Donut Hole?
Medicare Part D Donut Hole
4 stages of Part D
Part D deductible stage: first $435
Part D initial coverage stage: first $4,020, up to 25% of cost of medication
Tiers of medications in Part D
Part D tier 1 medications
Part D stage 3: donut hole, 25% patient responsibility
Part D stage 4: catastrophic stage, copay

Visit Mastering Medicare at MasteringMedicare.NET

]]> 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:

What is Part D Medicare
Opt in Part D
Premium calculation for Medicare Part D
What is the Medicare Donut Hole?
Medicare Part D Donut Hole
4 stages of Part D
Part D deductible stage: first $435
Part D initial coverage stage: first $4,020, up to 25% of cost of medication
Tiers of medications in Part D
Part D tier 1 medications
Part D stage 3: donut hole, 25% patient responsibility
Part D stage 4: catastrophic stage, copay

Visit Mastering Medicare at MasteringMedicare.NET

]]> Episode 3: Medicare Part B https://www.masteringmedicare.net/3 0b53d4f0-8427-4aff-948f-7f8ce5891ead Thu, 05 Mar 2020 08:00:00 -0500 Mastering Medicare full Mastering Medicare Mastering Medicare is a podcast helping demystify healthcare and Medicare for senior-serving professionals and providers. In this episode we do a deep dive into Medicare Part B. 29:27 no 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. We 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: What is Medicare Part B What services are included in Part B Professional services Part B Physical Therapy Part B Outpatient Labs Part B Outpatient Radiology Does Medicare pay for DME When does Medicare pay for 911 Medicare Part B is opt in How much does Medicare Part B cost Medicare Part B monthly premium Medicare covers part only 80% Medicare secondary insurance / Medigap / supplemental Part A vs Part B Physical Therapy Cost sharing for radiology Cost sharing for lab tests under Medicare Medicare limits on lab tests DME How do you order DME, wheelchair, hospital bed in a patient's home 13 month lease to own DME Same and similar DME Parachute same and similar DME Medicare, healthcare, physician, medical, senior care, eldercare, elder care, elder, seniors, part b 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.
We 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:

What is Medicare Part B
What services are included in Part B
Professional services
Part B Physical Therapy
Part B Outpatient Labs
Part B Outpatient Radiology
Does Medicare pay for DME
When does Medicare pay for 911
Medicare Part B is opt in
How much does Medicare Part B cost
Medicare Part B monthly premium
Medicare covers part only 80%
Medicare secondary insurance / Medigap / supplemental
Part A vs Part B Physical Therapy
Cost sharing for radiology
Cost sharing for lab tests under Medicare
Medicare limits on lab tests
DME
How do you order DME, wheelchair, hospital bed in a patient's home
13 month lease to own DME
Same and similar DME
Parachute 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.
We 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:

What is Medicare Part B
What services are included in Part B
Professional services
Part B Physical Therapy
Part B Outpatient Labs
Part B Outpatient Radiology
Does Medicare pay for DME
When does Medicare pay for 911
Medicare Part B is opt in
How much does Medicare Part B cost
Medicare Part B monthly premium
Medicare covers part only 80%
Medicare secondary insurance / Medigap / supplemental
Part A vs Part B Physical Therapy
Cost sharing for radiology
Cost sharing for lab tests under Medicare
Medicare limits on lab tests
DME
How do you order DME, wheelchair, hospital bed in a patient's home
13 month lease to own DME
Same and similar DME
Parachute same and similar DME

]]> Episode 2: Medicare Part A https://www.masteringmedicare.net/2 08848e81-05b1-42cd-bcdf-47db4496617c Wed, 26 Feb 2020 10:00:00 -0500 Mastering Medicare full Mastering Medicare Mastering Medicare is a podcast helping demystify healthcare and Medicare for senior-serving professionals and providers. We help physicians, NPs, APPs, healthcare executives, eldercare professionals, and other healthcare stakeholders understand and succeed in the Medicare and senior care world. 43:22 no 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. We 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: How you qualify for Medicare Qualifying for Medicare via ALS Qualifying for Medicare via ESRD on dialysis Qualifying for Medicare via SSDI disability Medicare and VA insurance History of Medicare Inpatient hospitalization Rehab aka SNF aka nursing home Home health Hospice Medicare copays and cost sharing for hospitalization Medicare part A annual deductible Medicare cost sharing with rehab SNF Medicare part A home health What is Home health? Home health 485 form What is skilled nursing? What does part A PT/OT do? Copay for part A PT OT Home health "taxing effort" Certification of being homebound home health Certification periods for home health Recertification of medicare part A home health Home health aides Home health 45 minutes twice per week Will Medicare pay for wound care supplies? Medicare hospice What is hospice Will Medicare pay for hospice Qualifying for hospice Hospice certification periods What does hospice cover and pay for Hospice payment model Who pays for a hospice patient if they go to the ER? Hospice is a risk bearing entity Hospice certification and recertification periods What does it mean to be admitted to a hospital Medicare, healthcare, physician, medical, senior care, eldercare, elder care, elder, seniors, Part A 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.
We 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:
How you qualify for Medicare
Qualifying for Medicare via ALS
Qualifying for Medicare via ESRD on dialysis
Qualifying for Medicare via SSDI disability
Medicare and VA insurance
History of Medicare
Inpatient hospitalization
Rehab aka SNF aka nursing home
Home health
Hospice
Medicare copays and cost sharing for hospitalization
Medicare part A annual deductible
Medicare cost sharing with rehab SNF
Medicare part A home health
What is Home health?
Home health 485 form
What is skilled nursing?
What does part A PT/OT do?
Copay for part A PT OT
Home health "taxing effort"
Certification of being homebound home health
Certification periods for home health
Recertification of medicare part A home health
Home health aides
Home health 45 minutes twice per week
Will Medicare pay for wound care supplies?
Medicare hospice
What is hospice
Will Medicare pay for hospice
Qualifying for hospice
Hospice certification periods
What does hospice cover and pay for
Hospice payment model
Who pays for a hospice patient if they go to the ER?
Hospice is a risk bearing entity
Hospice certification and recertification periods
What 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.
We 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:
How you qualify for Medicare
Qualifying for Medicare via ALS
Qualifying for Medicare via ESRD on dialysis
Qualifying for Medicare via SSDI disability
Medicare and VA insurance
History of Medicare
Inpatient hospitalization
Rehab aka SNF aka nursing home
Home health
Hospice
Medicare copays and cost sharing for hospitalization
Medicare part A annual deductible
Medicare cost sharing with rehab SNF
Medicare part A home health
What is Home health?
Home health 485 form
What is skilled nursing?
What does part A PT/OT do?
Copay for part A PT OT
Home health "taxing effort"
Certification of being homebound home health
Certification periods for home health
Recertification of medicare part A home health
Home health aides
Home health 45 minutes twice per week
Will Medicare pay for wound care supplies?
Medicare hospice
What is hospice
Will Medicare pay for hospice
Qualifying for hospice
Hospice certification periods
What does hospice cover and pay for
Hospice payment model
Who pays for a hospice patient if they go to the ER?
Hospice is a risk bearing entity
Hospice certification and recertification periods
What does it mean to be admitted to a hospital

]]> Episode 1: Introduction to Medicare https://www.masteringmedicare.net/1 3d05a2bb-826f-4a9f-ab72-f27b0e684116 Wed, 19 Feb 2020 08:00:00 -0500 Mastering Medicare full Mastering Medicare Mastering Medicare is a podcast helping demystify healthcare and Medicare for senior-serving professionals and providers. We help physicians, NPs, APPs, healthcare executives, eldercare professionals, and other healthcare stakeholders understand and succeed in the Medicare and senior care world. 35:59 no 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. We interview eldercare and Medicare industry experts, do deep dives into their companies, services, and experiences, and share their stories and insights with you. Brought to you by two passionate but critical physicians who broke away from the conventional career paths of their specialty. In this episode we cover: Dr. Amy Schiffman and Dr. Alex Mohseni introduce themselves Medicare overview Part A overview, including cost sharing Part A: Hospital, Rehab, Home Health, Hospice Part B overview Part B 80/20 split, Medigap / supplemental Part D Inpatient vs outpatient medications Inpatient vs outpatient status Observation status Part C - Medicare Advantage Join our Subscriber List to get your copy of our Medicare Cheat Sheet https://www.masteringmedicare.net/subscribe Medicare, healthcare, physician, medical, senior care, eldercare, elder care, elder, seniors 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.
We interview eldercare and Medicare industry experts, do deep dives into their companies, services, and experiences, and share their stories and insights with you.
Brought to you by two passionate but critical physicians who broke away from the conventional career paths of their specialty.

In this episode we cover:
Dr. Amy Schiffman and Dr. Alex Mohseni introduce themselves
Medicare overview
Part A overview, including cost sharing
Part A: Hospital, Rehab, Home Health, Hospice
Part B overview
Part B 80/20 split, Medigap / supplemental
Part D
Inpatient vs outpatient medications
Inpatient vs outpatient status
Observation status
Part C - Medicare Advantage

Join our Subscriber List to get your copy of our Medicare Cheat Sheet
https://www.masteringmedicare.net/subscribe

]]> 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.
We interview eldercare and Medicare industry experts, do deep dives into their companies, services, and experiences, and share their stories and insights with you.
Brought to you by two passionate but critical physicians who broke away from the conventional career paths of their specialty.

In this episode we cover:
Dr. Amy Schiffman and Dr. Alex Mohseni introduce themselves
Medicare overview
Part A overview, including cost sharing
Part A: Hospital, Rehab, Home Health, Hospice
Part B overview
Part B 80/20 split, Medigap / supplemental
Part D
Inpatient vs outpatient medications
Inpatient vs outpatient status
Observation status
Part C - Medicare Advantage

Join our Subscriber List to get your copy of our Medicare Cheat Sheet
https://www.masteringmedicare.net/subscribe

]]>