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1. You, a Medicare patient were hospitalized for pneumonia on January 22. After being discharged January 27th, you were admitted to the same hospital
1. You, a Medicare patient were hospitalized for pneumonia on January 22. After being discharged January 27th, you were admitted to the same hospital suffering from a broken leg caused by a fall in your home on February 4th. Would you be liable for another deductible fee for this new admission? YES/No. Why? (1.5 points) th 2. Based on question 1, you were discharged from the second hospital admission on February 9 and admitted to ABC Nursing Home for rehabilitative care. Will Medicare pay for this inpatient nursing care? YES/NO Why? (1.5 points) 3. Calculate the physician's Medicare reimbursement and the amount the patient must pay under the following scenarios: Given: Dr. Smith bills $120.00 for an intermediate office visit. The usual and customary Medicare payment is $75.00. a. What will Medicare pay if the physician accepts assignment? (.75 points) b. What will the patient pay if the physician does not accept assignment? (.75 points) 4. Dr. Tom Brady performs the following functions. Identify whether these functions are Part "A" Activities, Part "B" activities, or "N" non-reimbursable activities under the Medicare Program: a. Chairing the Sports Medicine Department (.75 points) b. Giving a second medical opinion on a patient's possible spinal surgery. (.75 points) 5. What is the single most important criterion the Internal Revenue Service uses to determine the Employee/Independent Contractor status? (1.5 points) 6. The books and records of ABC Home Health Agency have been destroyed in a fire. The Vice- President of Finance state to you, the independent auditor, that she has a copy of the financial statements for you to use to perform your audit. Can you perform an audit on the basis of this information? If not, what audit opinion could you render? Defend your answer. (1.5 points)
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