LPN / LVN
Other IDT Member
1. The resident’s doctor ordered an expensive chemo drug. It is not on the list of exclusions:
a. Charge the resident for the cost of the medication.
b. Refuse to give the drug; make the doctor change meds.
c. It is the SNF’s responsibility to pay for this medication.
d. Ask the resident’s family to supply the drug.
2. Your Medicare A resident needs gallbladder surgery now. The doctor wants the surgery to be performed at the hospital as an outpatient. It is not on the “inclusion” list:
a. The SNF would be responsible to pay.
b. The SNF is not responsible since the surgery is at the hospital and not “included.”
c. Encourage the resident to go to an outpatient surgical center not associated with the hospital to save money.
3. Your resident needs a PET scan (not on the exclusion list). Your facility cannot complete PET scans, so it will be done at the hospital.
a. SNF is responsible for the payment.
b. SNF is not responsible for the payment because it is outside of their scope of services they provide.
c. Insist the resident wait to have the PET scan until after he is off of Medicare A.
4. Resident was sent to a physician’s office along with notification to the physician that the resident was Part A. The physician provided treatment that was not approved by the SNF.
a. Refuse to pay the physician because he/she did not get the services pre-approved by the SNF.
b. Pay the services even though they were not pre-approved by the SNF.
c. Encourage the physician to bill Medicare Part B for the services.
5. Resident was sent to a physician’s office along with notification to the physician that the resident was Part A. The resident needed to be transported to the office by a medically necessary ambulance. Which of the following is true?
a. The resident can be billed for the ambulance fee.
b. The SNF is responsible for the ambulance fee.
c. The ambulance company can bill Medicare for the ambulance fee since the resident is Medicare A.
6. During your resident’s follow up appointment at the orthopedic surgeon’s office, an x-ray was taken. Who is responsible for payment of the x-ray?
a. The resident.
b. The SNF.
c. The physician can bill Medicare B.
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