Alta Vista Benefits, LLC

 Two Midnight Rule and Three Day stay for Medicare

I have been asked for clarification on the "Two Midnight" rule and the requirement for a three-day inpatient stay to qualify for a skilled nursing facility.  These are actually two different rules.

For a stay in a skilled nursing care facility to be paid by Medicare Part A, the enrollee must have an inpatient stay of three-consecutive days. This three days does not include the day of discharge or any time spent under outpatient observation. A patient may be in the hospital and not realize that they have not been admitted as an “inpatient.” 

 The “two-midnight rule” originally adopted by CMS in 2013 (and revised in 2016) provides a benchmark for medical providers to determine if it is appropriate to move a patient from “observation” to “admitted” status for Medicare purposes. In general, the rule provides that payment under Part A is appropriate if the admitting practitioner expected the patient to require a hospital stay that crossed two midnights and the medical record supported that reasonable expectation. The rule also provides flexibility to the provider, but states that services expected to last less than “two midnights” are generally not appropriate for coverage under Part A.

Once it is determined that a hospital stay is eligible for Part A coverage (i.e., the patient is admitted as in inpatient), the stay must cover three consecutive days in order for Part A to cover a stay in a skilled nursing facility. 

For more information about Medicare rules or to get help on your coverage, you can contact Alta Vista Benefits at 614-889-0934.

Alta Vista Benefits, LLC

How to handle unsolicited Medicare calls

 A lot of my clients are calling me asking about the number of unsolicited phone calls they are getting and how to stop them.  Please remember that this is strictily forbiddem for someone to call you without your written permission.  

Here is a suggestion on how to handle this.  Immedicately ask "do you have my written consent to contact me"? They will hang up immediately and make a note not to call you back.  

This may not stop the illegal calls, but it will slow them down.

How to apply for Medicare benefits

Virtual appointments with Alta Vista Benefits

With the advent of COVID-19, Alta Vista Benefits is changing the way we do business.  Many of our Medicare clients no longer want to meet in person.  To accommodate the needs of our current and future clients, we will be using a secure meeting to discuss plans and answer questions. This is effective immediately.  

All our clients will need is a smart phone, tablet or computer to access the online meeting. We can share our screen and give control to the client to sign any applications.  This is compliant with Medicare marketing guidelines.  

To check out our complete list of services, go to www.altavistaben.com

Virtual Medicare 101 training

If you are new to Medicare and confused about the information available, help is available.  If you have a computer, tablet or smart phone, you can now access Medicare 101 training online.  This training will discuss the basics of the types of coverage available, explain the differences and talk about when you can enroll.  Just visit www.altavistaben.com and look at the video on the home page. 

If you want a follow up conversation after you view the presentation, you can call our office at 614-889-0934 and talk with Lucy Grosz. Or, you can request an appointment with Lucy at lucy@altavistaben.com.

If you prefer, we can set up a virtual meeting with you, answer all of your questions and then help you enroll.  It is that simple and easy. We can do a full presentation with you without you ever leaving home.

Check it out!