What is the difference between Medicare Part A and Part B claims?

Medicare Part A and Part B serve different purposes within the Medicare program, and understanding their distinctions is essential. Medicaid Part A primarily covers inpatient hospital stays, skilled nursing facilities, hospice care, and some home health services. This type of coverage is crucial for individuals requiring hospitalization or extended medical care in a facility. Claims submitted under Part A usually involve services that are provided in a hospital or a similar setting, and the payment is typically based on a predetermined amount known as the diagnosis-related group. On the other hand, Medicare Part B focuses on outpatient care, such as doctor visits, preventive services, outpatient hospital services, and specific home health care. It is designed to cover services that do not require an overnight stay in a hospital. Claims for Part B services are processed differently since they usually require a fee-for-service model, where providers bill for individual services rendered. In summary, the main difference lies in the type of care each part covers: Part A is for inpatient services, while Part B is for outpatient services. For further information regarding specific claims or coverage, visiting the Humana Medicare website may provide helpful resources and details.