Inpatient Versus Observation Status

Inpatient vs. Observation status is a convenient pocket-size guide that equips admitting providers to determine a patient's admission status quickly, easily, and effectively. This pocket-sized guide contains tables and generally accepted guidelines for practitioners who admit patients. Each topic is usually covered on a single page, with an accompanying chart on the facing page, allowing for quick decision-making of the patient's admission status (inpatient versus observation). This makes it precise and easy to comprehend. By matching clinical findings with criteria charts, providers are able to quickly and easily determine if a patient is appropriate for inpatient or observation admission status. In addition, by providing tips for documentation you are able to write the correct admission orders initially, avoiding the headaches of time-consuming changes later, penalties, and/or loss of revenue.This pocket-size guide is ideal for physicians, medical students, interns, residents, NPs, PAs, dentists, and anyone else responsible for assigning the correct admission status.

This classic resource offers complete coverage of nursing case management - from theoretical background and historical perspective to practical applications and how the field is changing to meet the challenges of today's health care environment. It focuses on the implementation of various case management models used throughout the United States and abroad. Key topics include the impact of public policy on health care; understanding the effects of health care reimbursement and its application at the patient level; throughput and capacity management; the impact of the revenue cycle; compliance and regulatory issues; and principles needed to improve case manager-client interaction. This helpful resource is designed to help nurse case managers assess their organization's readiness for case management, prepare and implement a plan to achieve necessary improvements and evaluate the plan's success. Includes numerous proven case management models currently being used in institutions across the country Organized to take the nursing case manager on a journey from the historical development of nursing case management to the successful implementation of a case management program Offers detailed guidance for planning, implementing, and evaluating a case management program Outlines the planning process with information on key topics such as analysis of the organization, the role of the organization's members, selection criteria for new case managers, case management education, credentialing, and partnerships Features guidelines for implementing a case management program with information on ethical issues, technology, compliance, and regulatory issues Addresses the evaluation component of developing and implementing a case management program by presenting information on outcomes, research, documentation, continuous quality improvement, measuring cost effectiveness, care continuum, and evidence-based practice Presents acute care and community based models of case management Highlights the evolution of collaborative models of case management, addressing key elements of joint decision-making, shared accountability, and interdisciplinary systems of care Addresses health care delivery through case management and public policy by presenting current legislative issues and their affect on both health care reimbursement and the application of care at the patient level Presents the insights, experiences, and advice of nursing administrators who have researched and successfully implemented nursing case management programs in various facilities A new chapter, Telehealth Applications for Case Management, introduces the concept of telehealth; provides examples of telehealth usage in women's health, chronic disease management, and mental health; and summarizes the evidence that supports telehealth and identifies existing issues and challenges. Case Management: Life at the Intersection of Margin and Mission, is a new chapter that highlights strategies case managers and others can use to optimize their organizations' financial outcomes while simultaneously improving clinical outcomes for their patients. It emphasizes the work of case managers in the financial arena of health care, including revenue cycle management. A new chapter, Maximizing Reimbursement through Accurate Documentation and Coding, provides tips and strategies on maximizing reimbursement by designing and implementing programs focused on improving the physician's documentation. Effective Management Tools for Case Management Leaders: Strategy Maps and Balanced Scorecards, A Case Study is a new chapter that discusses strategy maps and balanced scorecards and their role in transforming an organization's mission and strategy into a management system and a comprehensive set of performance measures. Features updated information on HIPPA regulation (Health Insurance Portability and Accountability Act), patient safety and confidentiality issues, case management for Medicare patients, Medicare legislation, and utilization management.

Prepare for a new career as a case manager—or just upgrade your skills to a whole new level—with the newly updated Case Management: A Practical Guide for Education and Practice, 4th Edition. Ideal for case management certification (CCMC) exam preparation, this is a thorough review of the case manager’s many roles and skills, from acute to post-acute care. Whether you are a nurse transitioning to case management or already active in it, this is your road map to coordinating successful patient care, from hospital to home. Build a strong case management career foundation, with expert, evidence-based direction: NEW chapter on case manager orientation programs that offers orientation checklists, competency assessment, and learning profiles, with available online tools NEW topics on current practice issues and developments, including the impact of the Patient Protection and Affordable Care Act and value-based care NEW content on experiential, problem-based learning—learning practices, training programs, case management team professional development Offers in-depth, evidence-based guidance on: The case manager’s roles, functions, and tasks Key concepts—quality management and outcomes evaluation, legal and ethical considerations, case management process, utilization management, transitions of care The role of the nurse case manager versus social worker role Strategies that ensure effectiveness of case management models Coordinating care, protecting privacy and confidentiality, health insurance benefit analysis, practice standards The Case Management Code of Professional Conduct, accreditation agencies and standards, specialty board certifications Management of resources and reimbursement concepts Case management in various settings—acute care, emergency department, admissions, perioperative services, disease management, insurance case management, palliative care, end-of-life care, hospice, home health care, physician groups, public health/community-based care, rehabilitation Ideal preparation for the CCMC exam—offers a large portion of CCMC exam content—and for Continuing Education Unit (CEU) for Case Management study A must-have desk reference that offers plentiful case studies—considered to be “the bible” of case management

For more than 30 years, the highly regarded Secrets Series® has provided students and practitioners in all areas of health care with concise, focused, and engaging resources for quick reference and exam review. Emergency Medicine Secrets, 7th Edition, offers practical, up-to-date coverage of the full range of essential topics in this dynamic field. This highly regarded resource features the Secrets’ popular question-and-answer format that also includes lists, tables, pearls, memory aids, and an easy-to-read style – making inquiry, reference, and review quick, easy, and enjoyable. The proven Secrets Series® format gives you the most return for your time – succinct, easy to read, engaging, and highly effective. Fully revised and updated throughout, including protocols and guidelines that are continuously evolving and that increasingly dictate best practices. New chapter on Professionalism and Social Media Applications. Expanded coverage of cost-effective emergency medicine, as well as weapons of mass destruction including chemical, biologic, and radiologic weapons; explosives; and tactical medicine.?? Top 100 Secrets and Key Points boxes provide a fast overview of the secrets you must know for success in practice and on exams. Bulleted lists, mnemonics, practical tips from leaders in the field – all providing a concise overview of important board-relevant content. Multiple-choice questions online provide opportunities for further self-assessment. Portable size makes it easy to carry with you for quick reference or review anywhere, anytime.

Why is surgery so expensive? Surgeon Paul A. Ruggieri reveals little-known truths about his profession—and the hidden flaws of our healthcare system—in this compelling and troubling account of real patients, real doctors, and how money influences medical decisions behind the scenes. Even many well-informed patients have no idea what may be contributing to the cost of their surgery. With up-to-date research and stories from his practice, Ruggieri shows how business arrangements among hospitals, insurance companies, and surgeons affect who gets treatment—and whether they get the right treatment. Pulling back the curtain from the hospital bed, he explains how to safeguard one’s own health (and finances), and how America can make surgery more affordable for all without sacrificing quality care.

Observation services insight from the industry's top expert Here is the essential guide for understanding observation services and the most recent regulatory guidance for inpatient admission. Author Deborah K. Hale, CCS, CCDS, uses case studies and real-life examples to examine regulatory guidelines and fiscal management, and also explains how to manage multiple payers and find an easier way to achieve reimbursement for observation services. You will also learn about the roles of nurses and physicians in observation services and how to foster an effective team approach for compliance and appropriate reimbursement. With your copy of Observation Services, Third Edition, you'll learn how to: * Assign proper level of care using real-life case studies * Implement an effective and compliant policy in accordance with the Medicare rules for observation services and instruction * Implement a payer-specific policy in compliance with the multiple payers' rules for observation services and instruction * Determine improvement opportunities and understand how to use internal and external data * Decipher the dos and don'ts for Condition Code 44 What's new in the Third Edition? * CMS and American Hospital Association interaction regarding observation use * Updated guidelines on the process for use of Condition Code 44 and proper billing * The 2011 version of ST PEPPER * New and improved strategies for accurate billing * New examples of provider liable claims * New CMS instructions required for payment * New policy and procedure examples and case studies Topics covered include: * Determining the right level of care * The consequences of incorrect level of care determination * Correcting level of care determinations * Condition Code 44 * Using data to determine improvement opportunities * The role of the physician advisor * Strategies for achieving accurate reimbursement * The Medicare appeals process Downloadable tools include: * Appeal letter templates * Level of care decision-making flowchart * Revised PEPPER report example * Observation pocket card reference * UR physician documentation templates for Condition Code 44 * Transmittal 299 Condition Code 44 * MLN Matters Clarification Condition Code 44 SE0622 Here are just a few of the tools and forms you'll find in Observation Services, Third Edition. * Appeal letter templates and sample reports * Site of service decision-making flowchart * Non-physician review worksheet * Transmittal 299 Condition Code 44 * MLN Matters Clarification Condition Code 44 SE0622 * Top volume Medicare MS-DRGs You'll receive instructions to download these and all of the forms and tools so you can use them right away!

This guide to successful practices in observation medicine covers both clinical and administrative aspects for a multinational audience.

Hidden opportunities to improve profits in the healthcare industry abound in the area of discharge planning. The Discharge Planning Handbook for Healthcare: Top Ten Secrets to Unlocking a New Revenue Pipeline provides innovative new solutions that will show hospital administrators how to turn one of the most antiquated aspects of healthcare into one of the most productive. The performance-improvement concepts and approaches discussed in this volume balance all aspects of existing business models and provide a new approach to managing the discharge planning process. Management engineer and Six Sigma Black Belt Ali Birjandi and registered nurse and administrative director Lisa M. Bragg employ innovative solutions to help readers: Redefine the concept of discharge planning Assign the proper metrics The COS-Q snapshot – a new tool for success Employ Lean concepts in redesign Apply a practical approach to improvement Create a culture that produces results An extended case study invites managers and administrators to take an interactive approach to the learning and applying of these concepts. A spreadsheet tool is included to help readers stay on task in their quest to improve efficiency and quality of care. The approach and methods taught in this book have led to dramatic results in a number of institutions. When adopted by your organization, they can help to improve performance and boost revenue.

For 30 years, the highly regarded Secrets Series® has provided students and practitioners in all areas of health care with concise, focused, and engaging resources for quick reference and exam review. The 6th Edition of Emergency Medicine Secrets, by Drs. Vincent J. Markovchick, Peter T. Pons, Katherine M. Bakes, and Jennie A. Buchanan, features the Secrets’ popular question-and-answer format that also includes lists, mnemonics, tables, and an informal tone – making reference and review quick, easy, and enjoyable. Top 100 Secrets and Key Points boxes provide a fast overview of the secrets you must know for success in practice. The proven Secrets® format gives you the most return for your study time – concise, easy to read, engaging, and highly effective. Portable size makes it easy to carry with you for quick reference or review anywhere, anytime. NEW: Expert Consult access features online, interactive multiple choice questions for every chapter, perfect for self-assessment. Thorough updates keep you current with what’s new in emergency medicine.

While the vast majority of providers never intend to commit fraud or file false claims, complex procedures, changing regulations, and evolving technology make it nearly impossible to avoid billing errors. For example, if you play by HIPAA’s rules, a physician is a provider; however, Medicare requires that the same physician must be referred to as a supplier. Even more troubling is the need to alter claims to meet specific requirements that may conflict with national standards. Far from being a benign issue, differing guidelines can lead to false claims with financial and even criminal implications. Compliance for Coding, Billing & Reimbursement, Second Edition: A Systematic Approach to Developing a Comprehensive Program provides an organized way to deal with the complex coding, billing, and reimbursement (CBR) processes that seem to force providers to choose between being paid and being compliant. Fully revised to account for recent changes and evolving terminology, this unique and accessible resource covers statutorily based programs and contract-based relationships, as well as ways to efficiently handle those situations that do not involve formal relationships. Based on 25 years of direct client consultation and drawing on teaching techniques developed in highly successful workshops, Duane Abbey offers a logical approach to CBR compliance. Designed to facilitate efficient reimbursements that don’t run afoul of laws and regulations, this resource – Addresses the seven key elements promulgated by the OIG for any compliance program Discusses numerous types of compliance issues for all type of healthcare providers Offers access to online resources that provide continually updated information Cuts through the morass of terminology and acronyms with a comprehensive glossary Includes a CD-ROM packed with regulations and information In addition to offering salient information illustrated by case studies, Dr, Abbey provides healthcare providers and administrators, as well as consultants and attorneys, with the mindset and attitude required to meet this very real challenge with savvy, humor, and perseverance.

Reflecting emerging trends in today’s health information management, Health Information Technology, 3rd Edition covers everything from electronic health records and collecting healthcare data to coding and compliance. It prepares you for a role as a Registered Health Information Technician, one in which you not only file and keep accurate records but serve as a healthcare analyst who translates data into useful, quality information that can control costs and further research. This edition includes new full-color illustrations and easy access to definitions of daunting terms and acronyms. Written by expert educators Nadinia Davis and Melissa LaCour, this book also offers invaluable preparation for the HIT certification exam. Workbook exercises in the book help you review and apply key concepts immediately after you’ve studied the core topics. Clear writing style and easy reading level makes reading and studying more time-efficient. Chapter learning objectives help you prepare for the credentialing exam by corresponding to the American Health Information Management Association's (AHIMA) domains and subdomains of the Health Information Technology (HIT) curriculum. A separate Confidentiality and Compliance chapter covers HIPAA privacy regulations. Job descriptions in every chapter offer a broad view of the field and show career options following graduation and certification. Student resources on the Evolve companion website include sample paper forms and provide an interactive learning environment. NEW! Full-color illustrations aid comprehension and help you visualize concepts. UPDATED information accurately depicts today’s technology, including records processing in the EHR and hybrid environments, digital storage concerns, information systems implementation, and security issues, including HITECH’s impact on HIPAA regulations. NEW! Glossary terms and definitions plus acronyms/abbreviations in the margins provide easy access to definitions of key vocabulary and confusing abbreviations. NEW! Go Tos in the margins cross-reference the textbook by specific chapters. NEW Coding boxes in the margins provide examples of common code sets. Over 100 NEW vocabulary terms and definitions ensure that the material is current and comprehensive. NEW Patient Care Perspective and Career Tips at the end of chapters include examples of important HIM activities in patient care and customer service.

Eliminate sky-high wait times and increased denials in your ED Hospitals across the country are seeing extreme backup in the emergency department (ED). In recent years, well-structured emergency department case management programs have repeatedly demonstrated their value in: Influencing capacity Assigning patients to appropriate levels of care Targeting complex discharge needs Assisting with proper utilization review Whether you are looking to implement, maintain, or evolve your ED case management program, eliminate confusion surrounding the process with the help of Emergency Department Case Management: Strategies for Creating and Sustaining a Successful Program. Examining all perspectives of ED case management, this new and comprehensive guide will help you define a program that best suits your facility's needs. All the tools you need to get your program up and running From defining goals, clarifying roles, and understanding the necessary knowledge and skill sets required from ED case management staff, Emergency Department Case Management will help to ensure that you have a solid and sustainable foundation in place. After exploring models and reviewing your infrastructure, Emergency Department Case Management will help you outline key partnerships, present multiple options for case finding, tackle observation status, address quality and evaluation issues, and identify ways ED case managers can contribute to care coordination for complex pediatric, psychiatric, homeless, and uninsured populations. Written by Kathleen Walsh, RN, MS, and Karen Zander RN, MS, CMAC, FAAN, from the Center for Case Management, Emergency Department Case Management provides advice and best practices from two of the nations top case management experts. Take a look inside at the table of contents: Chapter 1: ED Case Management: The Heart of Access Chapter 2: The Foundation Chapter 3: Partnerships Chapter 4: The Process Chapter 5: Developing interventional strategies Chapter 6: Observation status determination Chapter 7: Program-level evaluation Chapter 8: Information system support Chapter 9: Quality Chapter 10: Addressing the pediatric population Chapter 11: Responding to the psychiatric population Chapter 12: Strengthening an existing program It's also packed with 15 detailed case studies discussing ED case management strategies, as well as five spotlight accounts detailing the experiences of ED professionals from across the country, including: A case manager A social worker A psychiatric nurse An information systems specialist An ED physician Don't hesitate to jumpstart your ED case management program. From beginning to end, Emergency Department Case Management will serve as the lead architect to help you design, build, and strengthen your ED case management model--order your copy today! Learning objectives: Conceptualize a framework for setting up an ED case management program Develop policies, procedures, and role descriptions Identify structural components, tools, and processes to support an ED case management program Describe potential outcomes of an ED case management program Who should buy this book? Emergency Department Case Management is the perfect resource for case managers, directors of case management, ED nurse managers, social workers, ED directors/administrators, and CFOs. HCPro Inc. has confirmed that none of the faculty presenters or contributors has any relevant financial relationships to disclose related to the content of this educational activity.The HCPro Risk-Free, Money-Back Guarantee If for any reason you're not completely satisfied with your purchase, return it within 30 days and you will receive a prompt, polite, 100% refund--no questions asked.

Healthcare in America is littered with confusing rules and unclear systems. The discussion is oft centered on misconstrued facts and downright lies. Some politicians claim that nobody ever died from lack of access, that the Affordable Care Act is unnecessary and American healthcare isn’t cost-prohibitive. Some claim no one has lost Medicare or Medicaid coverage and pre-existing conditions don’t threaten coverage. One thing that can’t be denied about American healthcare is how often the average consumer is left confused. “Earthquake: How the Ever-shifting Healthcare Model Victimizes Americans” uses an easy-to-understand metaphor that equates the ever-shifting healthcare system with tectonic plates: just as earthquakes create victims with every shift of tectonic plates, so does the unstable American healthcare system. Dr. Brian Casull, a physician and physician executive of over 40 years, provides information that will help you escape to solid ground, including discussions about: What drives healthcare cost and what you can do about it; What the Affordable Care Act does and doesn’t do; The on-going political assault on your healthcare including pre-existing conditions, preventive care and the 10 essential categories of care you rightfully deserve. “Earthquake” aims to give you, the average healthcare consumer, the information necessary to become informed about America’s healthcare system and understand the tectonic plates that make your healthcare shake and tremble. With this book in hand, you can stay up-to-date on America’s Healthcare in Transition.

This book provides a road map for the efficient and successful management of atrial fibrillation (AF) in the short stay unit. It describes the problem, defines the measures of successful treatment, elucidates interventions, and supplies the tools for achieving quality care. Organized in four parts, it covers the impact of AF on patient populations; the presentation and management of AF; the transition to the outpatient environment; and systems management. Topics include the economic consequences of AF; cardioversion and cardiac implantable electronic devices in AF management; education of the AF patient and discharge planning; and quality metrics in AF. The book also provides order sheets and process criteria with which institutions can successfully manage the AF patient in the short stay unit, thus optimizing patient outcomes, patient satisfaction, and operational efficiencies. Short Stay Management of Atrial Fibrillation is a valuable resource for cardiologists, emergency medicine physicians, electrophysiologists, and other healthcare professionals involved in AF management.

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 2019 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 2019 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! Note: Online subscriptions are for three-month periods. Previous Edition: Medicare Handbook, 2018 Edition ISBN 9781454884224

This critically acclaimed work makes the case for collaboration and shows that it can be greatly enhanced with conscious understanding and systematic effort. As a healthcare specialist who has worn many hats from direct care giver to case manager to documentation specialist, Colleen Stukenberg is able to – Show how to build trust and communication and demonstrates specific opportunities where collaboration can make all the difference Identify ways that quality of care and financial factors overlap and the advantages that can be garnered through an understanding of this Explain how those in different roles view information through different types of knowledge and how an understanding of each perspective makes it easier to find the best source for important answers Discuss the education and ever-increasing role of the clinical documentation specialist who is often involved in all facets of a patient’s progress, from intake and admission right up through discharge. As the author points out, good healthcare is dependent on the right person performing the right role, which promotes excellent collaboration. And when people are allowed to function in their proper roles, job satisfaction increases, which in itself leads to better attitudes, which then leads to even deeper levels of collaboration and with it, the successful promotion of safe, quality care.

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 2016 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 2016 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!

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