Addendum A Template Inserts for the Medicare Advantage Reinstatement by WesleyL

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									Addendum A: Template H2256-2004-67
Inserts for the Medicare Advantage Reinstatement of Skilled Services Letter

(From the choices listed below, insert only one paragraph, which is specific to the
services being reinstated, into the Medicare Advantage Reinstatement of Skilled Services
Letter template. Do not include all sample paragraphs or the paragraph headings.)



♦      [Member received medically necessary skilled care in an inpatient or extended
       care setting]


       The care you received was medically necessary. Medicare covers medically
       necessary skilled care needed on a daily basis; therefore you are not responsible
       for (Inpatient / Skilled Nursing Facility) services received at (Facility Name) for
       the following dates, (Date).


♦      [Member is receiving medically necessary skilled care in an inpatient or extended
       care setting]


       The skilled care you are receiving is medically necessary. Medicare covers
       medically necessary skilled care needed on a daily basis; therefore you are not
       responsible for (Inpatient / Skilled Nursing Facility) services received at (Facility
       Name), as of (Date).


♦      [Member still requires medically necessary skilled care in a home care setting]


       You still require medically necessary skilled Homecare services as defined by
       Medicare coverage guidelines; therefore, you are not responsible for Homecare
       services received from (Provider Name), as of (Date).


♦      [Medicare notification timeframe not met for an inpatient, extended care, or
       homecare setting]


       The required notification time was not met to inform you that skilled services
       would no longer be covered: therefore, you are not responsible for (Inpatient /
       Skilled Nursing Facility / Homecare) services received at (Facility or Provider
       Name) for the following dates, (Date).




                  Medicare Advantage Reinstatement of Skilled Services Letter_Addendum   H2256-2004-67

								
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