

Mastering Medicare
Mastering Medicare
What's the difference between Home Health and Home Care? How do Medicare Part A and Part B work? How do you order DME for your patient? When and how should you order home oxygen? What's new in the eldercare space?
For physicians, other healthcare professionals, and senior-serving professionals, interacting with Medicare can be complicated and wrought with pitfalls, which, if not understood and managed, will mire your practice in endless paperwork and frustration.
We interview industry experts in every aspect of healthcare, from insurance companies, DME companies, home health agencies, medical providers, and many others, to bring you their real world expertise in the American healthcare system.
Your hosts are Dr. Amy Schiffman and Dr. Alex Mohseni, two Emergency Medicine physicians who have branched off from traditional Emergency Medicine to explore and build solutions with a particular focus on eldercare and population health.
Join our Facebook group: https://www.facebook.com/groups/602747270479020/
Join our Subscriber List and get exclusive access to our Mastering Medicare Cheat Sheet and other goodies: https://www.masteringmedicare.net/subscribe
For physicians, other healthcare professionals, and senior-serving professionals, interacting with Medicare can be complicated and wrought with pitfalls, which, if not understood and managed, will mire your practice in endless paperwork and frustration.
We interview industry experts in every aspect of healthcare, from insurance companies, DME companies, home health agencies, medical providers, and many others, to bring you their real world expertise in the American healthcare system.
Your hosts are Dr. Amy Schiffman and Dr. Alex Mohseni, two Emergency Medicine physicians who have branched off from traditional Emergency Medicine to explore and build solutions with a particular focus on eldercare and population health.
Join our Facebook group: https://www.facebook.com/groups/602747270479020/
Join our Subscriber List and get exclusive access to our Mastering Medicare Cheat Sheet and other goodies: https://www.masteringmedicare.net/subscribe
Episodes
Mentioned books

Mar 14, 2020 • 35min
Episode 5: MOLST, POLST, and Advance Directives
Alex and Amy discuss the urgent need during this COVID-19 pandemic for folks to think about difficult end-of-life deicisions and they walk the audience through the details of filling out the MOLST form.
MOLST: Medical Orders for Life-Sustaining Treatment
POLST: Physician's Orders for Life-Sustaining Treatment
In this episode, we discuss:
What is a MOLST form
What is a POLST form
Why should we talk about end of life care
Coronavirus / COVID-19 concerns
When should you fill out a MOLST form?
Who should fill out a MOLST form?
Can you make copies of a MOLST form?
Where should you keep your MOLST form?
What is CPR?
What is intubation?
MOLST form options

Mar 10, 2020 • 16min
Episode 4: Medicare Part D
Dr. Amy Schiffman and Dr. Alex Mohseni explore Medicare Part D, discussing its stages, premiums, donut hole, and tiered medications. They cover the complexities of selecting a plan, deductible calculations, and patient responsibilities throughout the coverage stages.

Mar 5, 2020 • 29min
Episode 3: Medicare Part B
Physicians and other senior-serving professionals trying to operate within the complicated Medicare ecosystem must be constantly learning, as the landscape, rules, tools, and vendors are in constant flux.
We interview eldercare and Medicare industry experts, do deep dives into their companies, services, and experiences, and share their stories and insights with you.
Here are some of the topics that we cover:
What is Medicare Part B
What services are included in Part B
Professional services
Part B Physical Therapy
Part B Outpatient Labs
Part B Outpatient Radiology
Does Medicare pay for DME
When does Medicare pay for 911
Medicare Part B is opt in
How much does Medicare Part B cost
Medicare Part B monthly premium
Medicare covers part only 80%
Medicare secondary insurance / Medigap / supplemental
Part A vs Part B Physical Therapy
Cost sharing for radiology
Cost sharing for lab tests under Medicare
Medicare limits on lab tests
DME
How do you order DME, wheelchair, hospital bed in a patient's home
13 month lease to own DME
Same and similar DME
Parachute same and similar DME

5 snips
Feb 26, 2020 • 43min
Episode 2: Medicare Part A
Physicians and other senior-serving professionals trying to operate within the complicated Medicare ecosystem must be constantly learning, as the landscape, rules, tools, and vendors are in constant flux.
We interview eldercare and Medicare industry experts, do deep dives into their companies, services, and experiences, and share their stories and insights with you.
In this Mastering Medicare episode, we cover:
How you qualify for Medicare
Qualifying for Medicare via ALS
Qualifying for Medicare via ESRD on dialysis
Qualifying for Medicare via SSDI disability
Medicare and VA insurance
History of Medicare
Inpatient hospitalization
Rehab aka SNF aka nursing home
Home health
Hospice
Medicare copays and cost sharing for hospitalization
Medicare part A annual deductible
Medicare cost sharing with rehab SNF
Medicare part A home health
What is Home health?
Home health 485 form
What is skilled nursing?
What does part A PT/OT do?
Copay for part A PT OT
Home health "taxing effort"
Certification of being homebound home health
Certification periods for home health
Recertification of medicare part A home health
Home health aides
Home health 45 minutes twice per week
Will Medicare pay for wound care supplies?
Medicare hospice
What is hospice
Will Medicare pay for hospice
Qualifying for hospice
Hospice certification periods
What does hospice cover and pay for
Hospice payment model
Who pays for a hospice patient if they go to the ER?
Hospice is a risk bearing entity
Hospice certification and recertification periods
What does it mean to be admitted to a hospital

Feb 19, 2020 • 36min
Episode 1: Introduction to Medicare
Physicians and other senior-serving professionals trying to operate within the complicated Medicare ecosystem must be constantly learning, as the landscape, rules, tools, and vendors are in constant flux.
We interview eldercare and Medicare industry experts, do deep dives into their companies, services, and experiences, and share their stories and insights with you.
Brought to you by two passionate but critical physicians who broke away from the conventional career paths of their specialty.
In this episode we cover:
Dr. Amy Schiffman and Dr. Alex Mohseni introduce themselves
Medicare overview
Part A overview, including cost sharing
Part A: Hospital, Rehab, Home Health, Hospice
Part B overview
Part B 80/20 split, Medigap / supplemental
Part D
Inpatient vs outpatient medications
Inpatient vs outpatient status
Observation status
Part C - Medicare Advantage
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