Re: Medicare B vs. Medicare A

[C G]

Thank you all for the great responses to my question... I think i already understand it right.... gathering all the info. you gave me... Medicare Part B is considered skilled if Therapy Dept. is providing therapy 5x a week, that means resident does not qualify for another 100 days but  if they are just providing 3x per week thats not considered skilled

meaning resident qualifies for another 100 days...is this right?

Michelle Witges <[EMAIL PROTECTED]> wrote:

Now I am really confused.  I thought that Part B therapy 3 times a week was not considered skilled.  According to the Q&A in "Briefings on Long Term Care Guidelines" Kitt Wakeley, a consultant for Pinnacle Healthcare Group, states that Part B therapy would qualify as skilled service and therefore the 60 day would have to start over after Part B ended.  She quotes the Skilled Nursing Facility Manual (CMS pub 12, section 240) "A benefit period begins with the first day which a patient is furnished inpatient hospital or extended care service by a qualified provider....".  According to Kitt "extended care services" would include part B therapy.  Now I know that "consultant's" make mistakes but it would be nice if someone could clear this up, if able.  We all know how Medicare works and how we are not supposed to know what is going on.  Any clarification would be great.

Michelle

----- Original Message -----

From: Brenda Chance

To: [EMAIL PROTECTED]

Sent: Friday, December 05, 2003 8:50 AM

Subject: RE: Medicare B vs. Medicare A

Not so.  If she was receiving part b but was not skilled therapy, then she will qualify for another benefit period again.  Just because a resident receives part b, it must be at a skilled level per medicare a guidelines to keep a resident from receiving a new medicare a benefit period.

 

Brenda W. Chance, RN, RAC-C

MDS Coordinator

 

 

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-----Original Message-----
From: Corey [mailto:[EMAIL PROTECTED]]
Sent: Thursday, December 04, 2003 6:29 PM
To: [EMAIL PROTECTED]
Subject: Re: Medicare B vs. Medicare A

 

Sorry, I misread the initial.  Since she was receiving skilled services in October, even though paid for by Part B, she would need a 60 day period from the day after her last day of therapy, before you could re-skill after a 3 day hospital stay.

----- Original Message -----

From: C G

To: [EMAIL PROTECTED]

Sent: Thursday, December 04, 2003 5:22 PM

Subject: Medicare B vs. Medicare A

 

Hello, i just need someones direction for me to understand it right..... and maybe needs  supporting documentation too.

..... Resident has Medicare Part A from May 28-July 11...then in October 2003, Therapy pick her up on Medicare B, due to decline.... then in Nov. 17, 2003, she went to Hosp.  until 11/25/03....  Does she qualify for another 100 days on Medicare Part A? I thought she doesn't due to the fact that she received Therapy in October 2003 and that consi-

dered skilled (no matter what the pay source is) and no 60 days gap (wellness period).

Am I wrong with my interpretations with the guidelines? Pls. help me to clarify this. thank you... Happy Holidays... 

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