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December 19, 2014

December 19, 2014

Posted by **Barb** on Wednesday, May 12, 2010 at 9:49pm.

Mrs. Hall was admitted to the hospital for the first time this year on September 15. On September 25, she was transferred to a skilled nursing facility where she stayed until

October 30. She was discharged from the SNF with home health care and a walker.

Table 1

HOSPITAL AND SNF INSURANCE STAY DATA

Insurance Medicare Part A

Total days inpatient stay 10

DRG reimbursement for inpatient stay $13,648

Total hospital charges for inpatient stay $16,000

Total days of SNF stay 35

Total reimbursement charges for the SNF stay $23,000

Home health care approved amount $7,000

KEY: DRG = diagnosis-related group—a system of classifying patient diagnose

1. What reimbursement amount will the hospital receive from Medicare?

A. $12,856 C. $16,000

B. $13,648 D. $23,000

I chose B.

2. What’s the total amount the patient owes for the hospital stay?

A. $0 C. $1,980

B. $912 D. $16,000

I chose A

3. How much does the patient owe for the SNF stay?

A. $0 C. $1,710

B. $99 D. $2,300

I chose A.

4. What’s the total amount the patient owes for home health care?

A. $0 C. $2,500

B. $500 D. $7,000

I chose D.

5. What’s the total amount that Medicare will pay for the home health care, excluding DME

charges?

A. $2,000 C. $7,000

B. $2,500 D. $9,000

I chose C.

- reimbursement methodologies -
**Anonymous**, Thursday, May 13, 2010 at 2:04amYou only got #1 correct. I just took this test about 2 weeks ago and have the answers in front of me. i will walk you through it. in your book go to page 249....

#2. if the stay was for 10 days then she automatically owes $912 (annual deductible) so the answer is B. $912

#3. she was in the SNF which is free for the first 20 days. so, she pays $114 per day for the last 15 days. 114x15=1710. so the answer is C. $1710

#4. she pays 20% of her DME which is $2,500. 2,500x .20=500... so that would be B. $500

#5 the total amount medicare will pay for home health care is the amount for the DME which is $2,000 (patient pays $500) plus the $7,000 approved amount which equals.... D. $9,000

hopefully this makes sense to you as it took me a while to figure it out. good luck :)

- reimbursement methodologies -
**ROBLES**, Tuesday, August 3, 2010 at 10:00pm1-A, 2-B, 3-C, 4-A, 5-C

I took the pennfoster test and received a 100%

- reimbursement methodologies -
**Kim**, Wednesday, August 4, 2010 at 6:57pmRobles,

I am working on this exam right now. I am having problems with the question - What reimbursement amount will the hospital recive from Medicare? You say it is A. $12,856. What are your calculations? I just can't see how you came up with that amount.

If Robles or someone else could show me how to get $12,856 I would really appreciate it.

- reimbursement methodologies -
**ROBLES**, Sunday, August 15, 2010 at 4:55pmI ACTUALLY GUESSED AND GOT IT RIGHT.

PENNFOSTER EXAM

- reimbursement methodologies -
**Nadya**, Tuesday, January 4, 2011 at 10:01amHi guys.I am working with this exam too right now and I don't understand how you guys can came up with...

1. A or B? What calculate did u guys used?

4. $2500*20%. How that $2500 from?

5. $7000+$2000. How that $2000 from?

Thanks a lot for the feedback.

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