Medicare and Medicaid

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  • Icd Codes In Hospitals

    procedures to Medicaid, Medicare and third-party payers. HCPCS codes are split into to two levels: Level II and I. Level I includes CPT codes. HCPCS Level II consists of five characters, both numbers and letters and used to present services outside of a health provider’s office, ambulance, supplies and other non-physician services. CPT codes are used for the description of surgical, laboratory and other services of health care providers. It consists of five number or letter components. CPT codes are divided into 3 categories: Category I, Category II and Category III. Category I: codes for evaluation and management, anesthesia, surgery, radiology, pathology and laboratory, medicine. Category II: composite measures, patient measures, patient history, physical examination and diagnostic results. Category III: codes for emerging service. B) Describe, define and explain in detail how both Medicare and Medicaid each pay for of the following services: a) hospital in-patient services Medicare and Medicaid reimburse hospital in-patient services through the Inpatient prospective payment system. Each case is sorted into a diagnosis-related group, where each group has a fee appointed to it. Payment is calculated for variances in region wage prices and hospital status and characteristics. The IPPS reimburses a hospital using a flat rate by calculating the average charges for a particular illness throughout the hospital. b) physician professional services. Medicare and Medicaid pay…

    Words: 716 - Pages: 3
  • Misconceptions Of The Center For Medicare And Medicaid Websites

    Out of all the websites that I have reviewed, the most interesting one was the Center for Medicare and Medicaid Website to compare the hospitals in your home area. It shows how each hospital does on treating several different diseases and shows what the national average is in our country. I found this extremely helpful because it helped confirm some of my beliefs in the Oakwood system, but also showed the misconceptions of the Oakwood system. I had always known that they had an issue with giving…

    Words: 765 - Pages: 4
  • Difference Between Licensure And Accreditation

    the initial office of the director of the Joint Commission on Accreditation of Hospitals. Then in 1953 the Joint Commission on Accreditation of Hospitals started offering accreditation through them instead of the American College of Surgeons since they had officially transferred there onsite accreditation program over to the newly developed organization (The Joint Commission, 2015). . The Joint Commission on Accreditation of Hospitals develops their own set of standards and had the new…

    Words: 1612 - Pages: 6
  • Social Work Hope Case Study

    The hope is a multidisciplinary approach to care would produce a more comprehensive assessment and plan of care for the individual. Sometimes this is the case and other times it’s not. It really truly depends on the team members. Recently, we had a discharge planning meeting for a resident at our facility. The resident’s daughter is the Director of Admissions at our facility. Our social worker called her to explain that her father was making very little progress and she did not expect him to…

    Words: 839 - Pages: 4
  • Long Term Care In Nursing Home

    Long-term care is defined as health, mental health, residential or social support provided to a person with functional disabilities on an informal or formal basis over an extended period of time with the goal of maximizing the person’s independence. The goal of long-term care is help people achieve functional independence, in contrast to the goal of acute care, which is to cure. The fundamental reason that a person needs long-term care is because they suffer from one or more functional…

    Words: 734 - Pages: 3
  • Movie Analysis: Away From Her

    In this paper, we will discuss the movie Away from Her. We will talk about different problems encountered in the movie, their solutions and how the movie would look like today if it was set in Las Vegas. We also hope to share our own thoughts about how we would deal with Alzheimer’s disease if we were the patient. Away from Her is a very interesting movie about a fictitious couple named Grant and Fiona Anderson. Their characters are played by Gordon Pinsent, and Julie Christie, respectively…

    Words: 1732 - Pages: 7
  • Case Study: Marketization Of Home Care For Older People

    2.2 Marketisation of home care for older people The older care at home in this study would include the care services of personal routines, including nursing, body-related support, home help and befriending taken place at older people’s home by paid care worker rather than family members, following the embracement of domiciliary elderly care of Bode et al (2013) and Bolton and Wibberley (2014). The home care has been increasingly operated according to market mechanism and portrayed as the ideal…

    Words: 2126 - Pages: 9
  • Long Term Care Administrators

    Long-Term Care Administrators Long-term care (LTC) industry is predicted to experience a significant growth because of the simultaneous aging of the baby boomers, and consequently, their need for long-term care. Thus, the jobs or duties of LTC administrators will become more demanding, and more stressful. There are, however, some traits and training that LTC administrators will need in order to succeed. LTC administrator’s job is not for the faint-hearted because the job entails a lot of hard…

    Words: 888 - Pages: 4
  • Nurse Case Management Model

    The Pros of MLTC is to provide long-term care service to keep enrollees at home and community as long as possible. Also, MLTC program is cost and effective to manage Medicaid. All durable medical equipment’s applications need to send to plan that consumers have enrolled to get approval so that every dollar will be spent on the items that consumers really need. According to “The Long term Care Community Coalition(2013), “Care for nursing home residents, among our most vulnerable New Yorkers,…

    Words: 1293 - Pages: 5
  • Healthcare Budget Analysis

    public health support through Medicaid. (Cuts on the Rise, Health on Decline, 2011) At the same time change in payment rates under Medicare are expected to bring new pressures on hospital operating…

    Words: 1512 - Pages: 7
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