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July 30, 2015

Homework Help: reimbursement methodologies

Posted by Nadya Crouch on Tuesday, January 4, 2011 at 10:47am.

Can anyone please assist me, I need the anwser to this question--

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

2. What’s the total amount the patient owes for home health care?
A. $0 C. $2,500
B. $500 D. $7,000

3. 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

What formula do i follow for this question. I can't find any form on Penn Foster Text book p.249

Thanks alot for any feedback.

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