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Updated annually, this book provides concise easy-to-read descriptions of the Medicare and Medicaid federal health insurance programs for the aged, disabled and indigent. Includes legislative changes that affect all parts of Medicare, including Medicare Advantage and the prescription drug benefit.
To provide effective service in helping clients understand how they are goingto be affected by health care reform and how to obtain coverage, pursue anappeal, or plan for long-term care or retirement, you need the latest Medicareguidelines from a source you can trust - the 2013 Edition ofMedicare Handbook .Prepared by experts from the Center for Medicare Advocacy, Inc.,Medicare Handbook covers the issues you need to provide effectiveplanning advice or advocacy services, including:Medicare eligibility and enrollmentMedicare-covered services, deductibles, and co-paymentsCo-insurance, premiums, and penaltiesFederal coordinated care issuesGrievance and appeals proceduresFace-to-face encounter requirements for home health and hospice careMedicare Handbook also provides you with coverage rules for:Obtaining Medicare-covered servicesPrescription drug benefit and the Low-Income Subsidy (LIS)The Medicare Advantage ProgramDurable Medical Equipment (DME)Preventive servicesAppealing coverage denialsand an understanding of:The Medicare Secondary Payer Program (MSP)The Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS)Competitive Acquisition ProgramIncome-related premiums for Parts B and DThe 2013 Edition has been updated to include information andstrategies necessary to incorporate ACA provisions on behalf of people in needof health care.In addition, the 2013 Medicare Handbook will also help advocatescontest limited coverage under private Medicare Part C plans (MedicareAdvantage) and understand initiatives to reduce overpayments to MedicareAdvantage.Other Medicare developments discussed in the 2013 Medicare Handbookinclude:Implementation of important provisions of the Affordable Care ActBeneficiary rights, when moving from one care setting to anotherDevelopments in the Medicare Home Health and Hospice BenefitsAdditional information regarding preventive benefitsContinued changes in Medicare coverage for durable medical equipment
To provide effective service in helping clients understand how they are going to be affected by health care reform and how to obtain coverage, pursue an appeal, or plan for long-term care or retirement, you need the most current information from a source you can trust - Medicare Handbook. This is the indispensable resource for clarifying Medicare's confusing rules and regulations. Prepared by an outstanding team of experts from the Center for Medicare Advocacy, Inc., it addresses issues you need to master to provide effective planning advice or advocacy services, including: Medicare eligibility rules and enrollment requirements; Medicare covered services, deductibles, and co-payments; coinsurance, premiums, penalties; coverage criteria for each of the programs; problem areas of concern for the advocate; grievance and appeals procedures. The 2017 Edition of Medicare Handbook offers expert guidance on: Health Care Reform Prescription Drug Coverage Enrollment and Eligibility Medigap Coverage Medicare Secondary Payer Issues Grievance and Appeals Home Health Care Managed Care Plans Hospice Care And more! In addition, Medicare Handbook will help resolve the kinds of questions that arise on a regular basis, such as: How do I appeal a denial of services? What steps do I need to take in order to receive Medicare covered home health care? What are the elements of Medicare's appeal process for the denial of coverage of an item, service, or procedure? Does my state have to help me enroll in Medicare so that I can get assistance through a Medicare Savings Program? When should I sign up for a Medigap plan? If I am on Medicare, do I have to buy health insurance in the insurance marketplace created by the Affordable Care Act? Is it true that I have to show medical improvement in order to get nursing and therapy services for my chronic condition? And more! The 2017 Medicare Handbook is the indispensable resource that provides: Extensive discussion and examples of how Medicare rules apply in the real world Case citations, checklists, worksheets, and other practice tools to help in obtaining coverage for clients, while minimizing research and drafting time Practice pointers and cautionary notes regarding coverage and eligibility questions where advocacy problems arise, and those areas in which coverage has been reduced or denied And more!
A timely look at the healthcare valuation process in an era of dynamic healthcare reform, including theory, methodology, and professional standards In light of the dynamic nature of the healthcare industry sector, the analysis supporting business valuation engagements for healthcare enterprises, assets, and services must address the expected economic conditions and events resulting from the four pillars of the healthcare industry: Reimbursement, Regulation, Competition, and Technology. Healthcare Valuation presents specific attributes of each of these enterprises, assets, and services and how research needs and valuation processes differentiate depending on the subject of the appraisal, the environment the property interest exists, and the nature of the practices. Includes theory, methodology, and professional standards as well as requisite research, analytical, and reporting functions in delivering healthcare valuation services Provides useful process tools such as worksheets and checklists, relevant case studies, plus a website that will include comprehensive glossaries and topical bibliographies Read Healthcare Valuation for a comprehensive treatise of valuation issues in the healthcare field including trends of compensation and reimbursement, technology and intellectual property, and newly emerging healthcare entities.
To provide effective service in helping people understand how they are going to be affected by health care reform and how to obtain coverage, pursue an appeal, or plan for long-term care or retirement, you need the most current information from a source you can trust - Medicare Handbook. This is the indispensable resource for clarifying Medicare's confusing rules and regulations. Prepared by an outstanding team of experts from the Center for Medicare Advocacy, it addresses issues you need to master to provide effective planning advice or advocacy services, including: Medicare eligibility rules and enrollment requirements; Medicare covered services, deductibles, and co-payments; coinsurance, premiums, penalties; coverage criteria for each of the programs; problem areas of concern for the advocate; grievance and appeals procedures. The 2020 Edition of Medicare Handbook offers expert guidance on: Medicare Enrollment and Eligibility Medicare Coverage in all Care-Settings Medicare Coverage for People with Chronic Conditions Medicare Home Health Coverage and Access to Care Prescription Drug Coverage Medicare Advantage Plans Medicare Appeals Health Care Reform And more! In addition, Medicare Handbook will help resolve the kinds of questions that arise on a regular basis, such as: How do I appeal a denial of services? What steps do I need to take in order to receive Medicare covered home health care? What are the elements of Medicare's appeal process for the denial of coverage of an item, service, or procedure? Does my state have to help me enroll in Medicare so that I can get assistance through a Medicare Savings Program? When should I sign up for a Medigap plan? If I am enrolled in Medicare, do I have to buy health insurance in the insurance marketplace created by the Affordable Care Act? Is it true that I have to show medical improvement in order to get Medicare for my nursing and therapy services? And more! The 2020 Medicare Handbook is the indispensable resource that provides: Extensive discussion and examples of how Medicare rules apply in the real world Case citations, checklists, worksheets, and other practice tools to help in obtaining coverage for clients, while minimizing research and drafting time Practice pointers and cautionary notes regarding coverage and eligibility questions when advocacy problems arise, and those areas in which coverage has often been reduced or denied And more! Previous Edition: Medicare Handbook, 2019 Edition ISBN 9781543800456
This public domain book is an open and compatible implementation of the Uniform System of Citation.