COB Playbook

Creating a Timeline for a Patient

In our example, our patient’s name is Jack. In order to figure out Jack’s correct initial Medicare entitlement reason, we need to plot what happened for him on a timeline.  Jack is under Age 65 and began dialysis on 12/5/2013. He has had no training or transplant within the first 3 months of dialysis, nor has ever dialyzed before. Jack obtained Medicare on 2/1/2014.

MEDICARE A&B Entitlement

ESRD Entitlement

RCDB / FDODE

 We conclude Jack’s Initial Medicare Entitlement reason is DISABILITY because that entitlement came before the ESRD entitlement date.  We always have to keep in mind the patient’s 3 month waiting period. Medicare entitlement was before 3 month waiting period was over.