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Admissions and Billing Guidelines
Medicare has specific requirements regarding physician responsibilities and billing protocols for physicians who follow Hospice patients. To assist you, Hospice & HomeCare By The Sea has compiled the following guidelines when caring and billing for Hospice patients:
1.
PROCEDURE
A.
Give
verbal/written authorization for Hospice services. Call 800-392-3188.
B.
Sign
and return certification of terminal illness within 8 days of receipt.
Fax back to 561-395-0767.
C.
Participate
in the development and implementation of the Hospice Plan of Care.
D.
Sign
initial admission orders within 48 hours.
E.
Sign
verbal/telephone orders within 14 days.
F.
Provide
a recent History & Physical or dictate an update of the patient’s
condition with documentation citing the reasons for the referral.
G.
Maintain
a palliative approach to the management of pain and symptoms.
| 1) Treatment plans that are not part of the Hospice Plan of Care, (not authorized) and are aggressive or curative in nature will not be covered by Hospice. The Hospice Medical Director is always available to discuss appropriateness when in question. |
2
BILLING
GUIDELINES
Bill
Medicare Part B for:
1)
Professional physician services/office visits that are related to the
terminal diagnosis.
2) Overseeing the Hospice Plan of Care (exclude Nursing Home patients). See care plan billing info.
3) Medications/treatments rendered in your office that are not related to the terminal illness.
2) Overseeing the Hospice Plan of Care (exclude Nursing Home patients). See care plan billing info.
3) Medications/treatments rendered in your office that are not related to the terminal illness.
Bill
Hospice for:
1)
Medications and treatments delivered in your office that are related to
the terminal illness and are part of the Hospice Plan of Care (authorized):
- example: palliative radiation and chemo
- medications and treatments that are not part of the Hospice Plan (unauthorized) will not be covered by Hospice or Medicare and the patient bears the cost.
- example: palliative radiation and chemo
- medications and treatments that are not part of the Hospice Plan (unauthorized) will not be covered by Hospice or Medicare and the patient bears the cost.
2)
A consulting (not the attending)
physician providing professional services approved by Hospice, with the
appropriate CPT, code can bill Hospice for services.