Referring Patients to Assist Home Health
To refer a patient to Assit Home Health, please fill out the physician’s referral form completely. As it pertains to HIPPA, and the privacy of patient information, we take every precaution to maintain the highest level of security. Please contact us with any questions about our referral form at (361) 462.4569 and/or fax to (361) 356.4200.
Assist Home Health currently accepts Medicare and private insurance patients. Assist Home Health currently accepts Medicare and some HMO’s. Please call for complete list of insurances.
Services for patients with Medicare and private health insurance are provided based upon approval from Medicaid or the respective private insurance company. Please review the Medicare qualifications below for more information.
The Physician Orders Care
* All care provided by home health professionals MUST be ordered by the physician. The physician must SIGN a plan of treatment (485) and any additional or subsequent supplementary orders.
* The physician MUST be apprised immediately of any change in condition, whether that be an improvement in status, or a decline.
* If the patient is on Medicare, the physician can bill for the time spent on care plan oversight. See CMS sight for details.
* Orders MUST be signed by an MD, DO, or Podiatrist. They may NOT be signed by a PA or NP. Hopefully this will change soon.
FACE to FACE Requirements
For initial home health certifications, the certifying physician must document that the physician himself or herself, an allowed NPP, or a physician caring for the patient in an acute or post-acute facility who has privileges at the facility had a face-to-face encounter with the patient.
•The face-to-face encounter must occur within 90 days prior to the home health start of care date or within 30 days after the start of care.
•The face-to-face encounter can be performed via a telehealth service, in an approved originating site.
•Prior to billing, the home health agency should ensure that all certifications are complete, including that the face-to-face documentation that has been clearly titled, dated, and signed by the certifying physician.
This statement is found in a pdf document available online from the CMS site
Face to Face Requirements are changing. Stay tuned to CMS for news on the new rules.
Medicare Qualification Criteria
Assist Home Health works with Medicare to ensure our patients get the right home health care and attention they require. Patients must meet certain qualifications approved by Medicare, therefore we ask that you review the following information:
1. The physician must decide if the patient requires medical care at home and create a plan for the patient’s care at home.
2. The patient must require at least one of the following: intermittent skilled nursing care, physical therapy, speech-language therapy, or continue to need occupational therapy.
3. The patient must be homebound, or normally unable to leave home unassisted. To be homebound means that leaving home takes considerable and taxing effort. A person may leave home for medical treatment or short, infrequent absences for non-medical reasons, such as a trip to the barber or to attend religious service. A need for adult day care doesn’t withhold the patient from qualifying home health care.
You may visit the Medicare website for expanded information regarding your current Home Health Care coverage as well as many other coverage topics under the Original Medicare Plan.
Physicians can sign their plan of care through our Kinnser Software, they can also review the plan of care that the clinicians have generated. They can also review communication notes, lab orders, and PRN visits.
