Answer to Question 1
Answer:
There is a Part A deductible amount that is taken from the first inpatient hospital admission. The use of Medicare benefits for an inpatient is measured by benefit periods. A benefit period begins with the first day of admission to the hospital. A benefit period ends after the patient has been discharged from the hospital or skilled nursing facility for a period of 60 consecutive days (including the day of discharge). A new benefit period begins and another inpatient deductible would be taken if the patient were readmitted.
For example if the Part A deductible is 1,000.00 per benefit period and a member remains in the hospital for an extended period of time, additional copayments are required. Medicare deducts the copay amount from the billed amount and then pays the amount in excess of the copay.
The inpatient hospital copayments are calculated as follows:
1st day60th day = deductible only, no additional copayment
61st day90th day = additional copayment per day
91st day150th day = higher additional copayment per day
Answer to Question 2
D
Verification of benefits worksheet.
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