When seeking reimbursement for OT services, remember that insurances use ______. Keep that in mind when determining how much to bill.

True or False: Ideally, group therapy should not cost the same as individual therapy.

True or False: Currently, COTAs and OTRs receive the same reimbursement for services.

When a patient has a stroke, where are they usually sent first?

In this setting, patients must be able to tolerate 3 hours of therapy a day, and have nursing needs that cannot be taken care of at home.

This setting is like in-patient, but not as intense. Here, patients need skilled therapy but are unable to tolerate 3 hours a day.

This setting is for people who have skilled nursing and therapy needs. However, they cannot tolerate 3 hours of therapy a day, but are expected to go home.

These are often nursing homes

In this setting, the patient lives at home and goes to rehab appointments.

In this setting, the patient goes home and has a therapist come to them to provide therapy. (However, in order to qualify, the patient must be homebound or unable to leave home without help)

The majority of people ages 65 and up have _____

Which part of Medicare covers inpatient hospitals and ER visits?

Which part of Medicare covers outpatient services and treatment at physician offices?

The ______ is used by insurances to determine payment. Specifically, Medicare pays the hospital a fixed amount based on this.

Under Medicare, a(n) ________ gets a flat rate to pay for care, no matter how many days a patient stays.

In acute rehabilitation, there is a formula for Medicare. Medicare examines all of the following, except:

______ estimates the number of days that it will take for someone to be discharged from the hospital, and pays for that amount. Whether a person is discharged at 15 days, or in 30 days, the hospital gets the same amount of money.

Medicare will pay for 100 days of stay in a Skilled Nursing Facility. However, during the first ______, there is no copay. After this, the copay will begin.

Medicare will cover the first 100 days of a stay in a Skilled Nursing Facility. After this time, how much is the patient responsible for paying?

True or False: Therapists in Skilled Nursing Facilities (SNFS) should strive to do as much therapy as possible within the first 20 days of a patient's admission.

If a patient is discharged from a SNF and is NOT readmitted to any hospital/facility within ______, Medicare will reset their SNF coverage.

If it has been established that a patient will not improve, Medicare will typically stop covering their care. As a result, patients usually must switch to ______

This assessment must be used in rehabilitation settings

In Skilled Nursing Facilities, therapists must use ______ for Medicare coverage.

The MDS (Minimum Data Set) must be completed within _____ of the patient's admission

Beginning in 2019, the ____ will be a new payment system implemented into SNFs.

Instead of looking at therapy minutes and determining the number of therapy minutes that were used, Medicare is now going to use the _____ to have reimbursement that is based on functional scoring.

Beginning in 2020, in-patient facilities will no longer use ____.

Beginning in 2020, in-patient settings will start using the GG section of the _____

Recently, the _____ cap was repealed. (However, once a patient reaches a certain amount, the OT has to request for more therapy).

The current OT therapy cap is at _____

Depending on the setting, which part of Medicare can also cover Durable Medical Equipment (DME)?

Which setting uses the OASIS to charge or bill for services?

A ____ or ____ has to do the initial eval in home health settings. It CANNOT be done by an occupational therapist.

Under the PDPM, any ____ that happens in a facility that causes major injury to a patient will affect how much the hospital is reimbursed.

The ____ section of the MDS focuses on discharge scores and how much a patient improves.

Medicare is changing their payment method for hospitals. One change is about readmission rates. Specifically, if a discharged patient returns to a hospital within 30 days due to a _______, the hospital will not be paid.

Education, using safe transfer techniques and removing physical barriers are all ways of preventing ______

Run by Medicare.gov, the _____ is a tool to measure the quality of nursing homes.

When planning for ______, an OT can take a patient to the gift shop, practice managing bills, and practice medicine management.