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Physician Services

Physicians have been referring patients to Home Health & Hospice Agencies for Skilled services for decades without knowing that they could be getting reimbursed for time spent supervising & coordinating care for their patients. 
 

CMS (then HCFA) has been reimbursing Physicians for Home Health Supervisory services since 1995.

A very small population of Physicians bill for these services because of the tedious manual process of tracking, recording and reporting. We can work with Home Health Agencies to make the documentation process easier for Physicians.

Billing For Home Health Services

MD's can bill for Home Health Initial Certification & Re-certifications if they:

  • Review patient reports & qualify patients for Home Health Services

  • Develop & review the Home Health Plan of Care in collaboration with a Home Health Agency

  • Certify a patient for a Home Health episode

 

 

 

 

 

Physicians can bill for Care Plan Oversight monthly, for 30 or more minutes spent on the following:

  • Ongoing review of reports, order, treatment plans, changes in patient status, lab/study results

  • Collaboration with other health care professionals involved in the patient's care over the phone or in person

  • Development and/or revision of the plan of treatment

  • Integration of any new information into the plan of treatment

  • Adjustment of medical therapy

  • Coordination of services that require the skills of a physician

  • Time spent on revision of the care plan after pertinent information has been conveyed

 

Documentation Requirements

The Physician must retain the following documents & incorporate them into their chart for the patient:

  • The Plan of care (Form 485) for Initial Certification and/or subsequent Re-certifications 

  • All orders given by the physician to the Home Health Agency for the pertinent patient

  • The Physician documentation must reflect that at least 30 minutes were spent on oversight of the home care plan of care during the month for which services are billed

  • Claims must be submitted by the Physicians staff or billing agency & not the Home Health Agency

 

Retroactive Billing Lookback

 

Our Clinical QA Staff will coordinate with the Physician staff and the Home Health Agency to::

 

  • Access the Medicare Common Working File for each patient

  • Track each patient vs Home Health Agency that provided care

  • Collaborate with Home Health Agency & acquire necessary documentation for Physician billing

  • Coordinate with other ancillary service providers such as DME, imaging etc. to acquire copies of Physician orders

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