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How does a doctor’s participation in Medicare affect reimbursement?
Medicare reimbursement refers to the payments that hospitals and physicians receive in return for services rendered to Medicare beneficiaries. The reimbursement rates for these services are set by Medicare, and are typically less than the amount billed or the amount that a private insurance company would pay.
Four reasons to change your Medicare Advantage coverage
If you're enrolled in a Medicare Advantage plan and you're not happy with it, you can switch plans during Medicare's annual open enrollment period. Here are four reasons why you might change coverage.
Important Medicare enrollment dates
Enrollment dates for Medicare are critical. Missing an enrollment date could cost you higher premiums down the line — or it could cost you coverage entirely.
Readmission to the hospital within 30 – 90 days of being discharged is an issue that Medicare and hospitals have been working to address. The federal government has programs in place that aim to reduce the prevalence of readmissions for patients with several significant medical conditions, and the data indicate that these programs are achieving success.
Poor coordination and communication sometimes play a role in readmissions, so it is necessary that patients and their family advocates take charge and ask the right questions. Lack of follow-up services accounts for many of the readmissions as well, so here are some key questions to ask to ensure you understand the discharge process, your after-care needs, and services you should be receiving:
To learn more, we suggest the following articles: Hospital Discharge Planning Checklist, Tips for a Better Hospital Stay, and A Safe Return Home from the Hospital. If you believe you are being discharged too soon and do not have adequate support to care for yourself, talk to your doctor or discharge planner about your options. You have the right to appeal the decision to discharge you.
Shannon Martin, M.S.W., CMC, is Director of Communications at Aging Wisely, LLC, a comprehensive care management company and EasyLiving, Inc., a licensed home care agency, in Clearwater, FL. Prior to Aging Wisely, Shannon served as social services director and admissions coordinator in an assisted living/skilled nursing facility and worked as a social worker and volunteer coordinator for a large hospice in Atlanta, Ga.