McareA, McareB, Skilled Mcaid, 60 day break

To explain all those items, it would take hours. Do you have more specific questions?

Do you have computer skills? Have you heard of google? Go to Medicare.gov

Medicare A is inpatient, Medicare B is outpatient, including skilled PT/OT when a patient in a SNF is not under a skilled stay (Medicare A, and HMO,or private insurance paying a per-diem rate) A 60 day break is when Medicare A skilled services end, and the patient receives no "skilled services" for at least 60 days. Then they start over with a new 100 day certified SNF stay if they have a 3 day hospital stay and have a skilled need. A patient who is taken off skilled services has a "30 day window," in which to be picked up again under Med A. If it is between 30 and 60 days, the patient does not usually qualify for a new stay.
Our corporation requires us to PPS all private insurance and HMO recipients, even when the coverage does not meet PPS guidelines

Treat every payor source as if it were medicare or medicaid. This will save you a lot of pain in the long run when you find out that the resident was actually medicare and NOT private insurance.