Case Management

Mentor moment: Who is tracking Medicare benefit days?

Case Management Weekly, May 23, 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?

Who is responsible for understanding and monitoring 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 Medicare allows 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?


Editor’s note: The preceding article is adapted from a column by Loretta Olsen, RN, MSN, ACM, director of case management at Mercy Medical Center North Iowa in Mason City, in the May Case Management Monthly published by HCPro, Inc.

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