Case Management

Mentor Moment: Who is tracking Medicare benefit days?

Case Management Weekly, April 18, 2012

Our seniors seem to be getting more chronically ill. These days, they don’t present to the hospital with simple pneumonia—they bring with them a whole list of comorbidities, resulting in complex cases that the physician and other healthcare providers must manage.

Since most of these patients are Medicare beneficiaries, who is managing their benefit days? Whose responsibility is it to understand and monitor a patient’s remaining days in a Medicare benefit period? Do beneficiaries and healthcare professionals understand what a benefit period is, how many inpatient days are allowed in a benefit period, and what it costs the Medicare patient for a hospital stay?

What does it mean when a patient has no inpatient or SNF days left?
A Medicare benefit period begins the day a hospital admits a patient as an inpatient and ends when the patient has not received any inpatient hospital care for 60 consecutive days. There is no limit to how many benefit periods a patient may receive.

Read the rest of this post and more on HCPro’s Case Management Mentor blog.

Most Popular