Hospital manual.

  • United States Social Security Administration
Date:
1967]
Catalogue details

Licence: Public Domain Mark

Credit: Hospital manual. Source: Wellcome Collection.

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    GENERAL INFORMATION ABOUT THE PROGRAM 104. Disclosure of Information.—The prohibition against disclosure of program information extends to the beneficiary’s health insurance claim number and the fact of his entitlement to health insurance benefits. Disclosure of information to State welfare agencies may be made under certain conditions. 110.2 Posthospital Extended Care Services.—The day of admission, but not the day of discharge, is counted in computing the 3-day prior hospital stay. 110.3 Posthospital Home Health Services.—The 100 home health visits under Part A must be furnished after the beginning of one spell of illness and before the beginning of the next. 122.2A Beginning of Coverage.—The initial general enrollment period for Part B was extended through September 30, 1966, when there was good cause for failure to enroll timely. 122.3C2 End of Coverage.—A social security railroad retirement beneficiary, who was enrolled as a public assistance recipient and then ceases to be a public assistance recipient, may terminate his medical insurance coverage within 3 months thereafter. Chapter II COVERAGE OF HOSPITAL SERVICES 202. Hospital Emergency Services.—The appropriate social security regional office with medical consultation by Public Health Service makes the determination of whether an emergency existed. Notices of emergency admissions and billings by nonparticipating hospitals are submitted to the local social security district office and payment is made by intermediaries designated by the Social Security Administration. 202.1 Definition of Emergency Services.—The determination of emergency services depends upon two findings: (1) The patient’s condition; and (2) the availability of facilities. Guide- lines on what constitutes “the most accessible hospital” are being developed. 202.2 Termination of Emergency Services.—An emergency no longer exists when it becomes safe from a medical standpoint to move the patient. 202.3 Physician’s Supporting Statements.—Details of required documentation are given. 205-205.3 Certification of Parts of Institutions as Hospitals.—The parts of institutions certifiable as participating hospitals are clarified. 206. Christian Science Sanatorium.—Sanatorium services are considered hospital services benefit days is explained. 210. Covered Inpatient Hospital Services.— “Inpatient” is defined. 210.1 Accommodations. 210.1B. <A hospital having only private accommodations can be paid only the equivalent of necessary. Where a patient is placed in a private room because less expensive accommodations are not available, the hospital can be reimbursed only for the reasonable cost of semiprivate accommoda- tions. The hospital may not charge the patient for the difference unless the patient requested private accommodations with the knowledge that he would be charged the difference. I