Home Health Basics
What are the disciplines we offer through home health?
What is:
Skilled Nursing
Physical Therapy
Occupational Therapy
Speech Therapy
Medical Social Services
Certified Nursing Assistants
To qualify for home health the patient must be considered this- unable to leave home without a considerable taxing effort
What is Homebound?
What is the most common category we bill for?
MS Rehab
What is the Plan of Care?
A plan of care identifies patient-specific measurable outcomes and goals, and is established, periodically reviewed, and signed by a doctor of medicine, osteopathy, or podiatry acting within the scope of his or her state license
How soon should home health initiate care?
What is within 48 hours
How long do we have to bill traditional Medicare?
365 days
What is the purpose of home health?
Home Health provides teaching and education for families and patients regarding medications, wound care and disease management.
Therapy services to help the patient be more independent in their home.
How long do we have to bill UHC Medicare Advantage?
90 days
How long do we have to submit and OASIS?
30 days
Who is an appropriate home health patient?
Who is:
1. Require skilled services
2. Are under a physician’s care- Physician (MD or DO) must certify the need and establish/sign the Plan of Care (the “485”)
3. Must be homebound
What does OASIS stand for?
Outcome and Assessment Information Set
What is a typical reimbursement rate per patient episode?
$3600
What do we need for a complete referral to home health?
Face Sheet (Demographics with insurance information)
Progress/Operation Notes/Labs
History and Physical
Orders
Face to Face Encounter
Primary Care Physician to follow the patient
True or False:
We are able to complete the plan of care order without the Face to Face documentation?
False. We must have the F2F documentation to complete the plan of care.
We are required to submit orders to the MD for signature withing ____days and have them signed within ____ days.
7 days; 30 days