Please check my answer thanks :)
Mrs Jones was addmitted to the hospital for the first time this year on 9/15. On 9/25 she was transferred to a SNF where she stayed until 10/30. She was dicharged from the SNF with home health care and a walker along with the information below please answer the questions that follow
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HOSPITAL AND SNF INSURANCE STAY DATA
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INSURANCE Medicare Part A
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Total days inpatient stay 10
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DRG rembur for in PT stay $13,648
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Total hosp charges for in Pt $16,000
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Total days of SNF Stay 35
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Total rembur charges for SNF $23,000
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HHC care approved amount $ 7,000
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Cost of walker from HHC $ 2,500
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What reimbursement amount will the hospital receive from medicare ?
I said $13,648
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What is the total amount that the patient owes for the hospital stay ?
I have no idea I think it's nothing
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What is the total amount the pt owes for HHC ?
I said nothing
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What is the total amount Medicare will pay for the HHC ?
I said $7,000
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How much does the pt owe for the SNF stay?
I am not sure how to figure this one out
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To determine the reimbursement amount the hospital will receive from Medicare, you are correct. It is $13,648. This is calculated based on the Diagnosis-Related Group (DRG) payment system used by Medicare for inpatient hospital stays. The DRG payment is a fixed amount based on the patient's diagnosis, regardless of the actual cost incurred by the hospital.
Regarding the total amount that the patient owes for the hospital stay, we need to consider their insurance coverage. In this case, Mrs. Jones has Medicare Part A, which covers inpatient hospital stays. Medicare Part A has deductibles and co-insurance that the patient may be responsible for. Therefore, the patient may owe a portion of the total hospital charges. To determine the exact amount, we would need to know the details of Mrs. Jones' specific Medicare plan and any additional insurance coverage she may have.
Similarly, for the total amount the patient owes for Home Health Care (HHC), we need to consider Mrs. Jones' insurance coverage. Medicare Part A generally covers a certain portion of the approved amount for HHC services, after deductibles and co-insurance. However, there may still be out-of-pocket costs for the patient. Again, the specific details of Mrs. Jones' Medicare plan and any additional insurance coverage would be needed to determine the exact amount.
To calculate the total amount that Medicare will pay for the HHC, you are correct that it is the approved amount, which is $7,000 in this case. This means that Medicare will cover up to $7,000 for the HHC services.
Finally, to determine how much the patient owes for the SNF stay, we would need details on Mrs. Jones' insurance coverage for skilled nursing facility (SNF) care. Medicare Part A generally covers a certain portion of the approved amount for a specified number of days in the SNF. Again, deductibles, co-insurance, and any additional insurance coverage would need to be considered to calculate the specific amount owed by the patient.
In summary, without detailed information about Mrs. Jones' insurance coverage and specific plan, it is not possible to accurately determine the total amount owed by the patient for the hospital stay, HHC, and SNF stay. It is essential to review the terms and conditions of the insurance policy and any relevant billing statements to determine the patient's financial responsibility.