The average billing for Care Plan Oversight (CPO) is $125.08 for home health and $132.55 for hospice. Billing codes are GO181 and GO182, respectively. To bill for this oversight service, it is important for physicians to keep records of:

• any revisions to care plans,
• review of subsequent reports of patient status,
• review of related laboratory or other studies,
• communication (including telephone calls) with other healthcare professionals involved in the patient’s care,
• integration of new information into the medical treatment plan, and/or
• adjustment of medical care.

Documentation is an important part of this process. It is imperative that physicians keep records, since Medicare may request this information as part of the post-payment review activities. A HOME HEALTH AGENCY MAY NOT MAINTAIN THIS DOCUMENTATION FOR THE PHYSICIAN.

Some ideas to simplify documentation include:

• Identify/flag charts of all Medicare patients who receive home health or hospice.
• Store charts on a separate shelf as an “extra” reminder to note and time all encounters to home health/hospice agency.

Develop a Care Plan Oversight form to include in the patient record for easy documentation.

The average billing for home health certification is $75.42, and $57.13 for recertification.

Documentation is important for billing this certification service as well. Physicians should at least retain a copy of the signed HCFA-485 (home health plan of care), signed interim or telephone orders, or any other documentation that would support the provision of these services.

REFERRAL PROCESS UPDATE

Geisinger Health Plan announced in May that effective July 1, 2004, there will be a referral precertification process change for Geisinger Health Plan participants. The new process will require SUN Home Health Services to acquire the necessary information for the precertification process, rather than utilizing this service through the Geisinger Home Health/Hospice Network. The new process will allow for physicians’ offices to call SUN Home Health Services, Inc. directly, thus eliminating the initial phone call to the Geisinger Home Health/Hospice Network.

With this process change, it is important to remember that patients have a CHOICE for their home health and hospice provider. SUN Home Health Services, Inc. is the area’s largest, most comprehensive provider with an outstanding reputation for service. When you call, anytime of the day or night, a SUN Home Health Registered Nurse will answer your call, and get you the help or information you need and deserve for your patients.

SUN Home Health Services, Inc. offers a full range of home healthcare services including pediatric, psychiatric, cardiac, hospice, and rehabilitation services. SUN Home Health is one of the only area providers using telehomecare, offering live two-way communication with our patients and their caregivers through video phone communications.

If you have any questions or require more information, please do not hesitate to contact SUN Home Health Services at 1-888-478-6227.

PLEASE TAKE NOTE
Your signature is very important! Regulations require that your signature be received within a specific timeframe so that the services that you ordered can be delivered to your patients as requested.

• Hospice orders – Certification of terminal illness required to be received within 5 days.
• Verbal orders and Plan of Treatment – Required to be received within 30 days.

Don’t delay! Please respond as soon as possible upon receiving the orders from SUN Home Health. Save postage and time by faxing to (570) 473-3070.

SUN HOME ACCEPTS EVENING/ WEEKEND ADMISSIONS

SUN Home Health Services has registered nurses on staff 24-hours a day, 7 days a week in our Health Information and Referral Center. Evening shift and on-call nurses are also available to make patient visits.Our availability makes it much easier for us to meet your needs and those of your patients.

To make a referral, call 1-888-478-6227.