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Pulse Home Health Care practices skilled health care procedures firmly rooted in the latest research and best practice policies. We routinely mail bulletins to physicians and other medical referral sources to highlight how we help patients and to explain the scientific basis for different services. Here we share selected physician bulletins about Pulses' Home Health Services. If you have questions about how home health could help you, please contact us today.

How to Avoid Denials

for Your Medicare Patients

A large Medicare fiscal intermediary, Palmetto, has completed an expansive study and concluded that, when Medicare denies your patients’ home health benefits, the number one reason is documentation of the face-to-face visit with the doctor.  In fact, across several states, out of all possible reasons to deny the benefit, documentation of the face-to-face visit was the reason 38% of the time.  What’s more, Medicare now states that it will increase scrutiny on the initial documentation of home health orders, most likely denying even more patients their home health benefits.  The good news is that the challenges with the documentation appear to be nothing more than a matter of acclimation to the new system.

It’s not that the visits are not occurring.  It’s simply that in many cases, the doctors’ narratives on the face-to-face documentation often fall short of painting the picture Medicare reviewers want.  We have been informed that reviewers stop at the narrative.  If the doctor’s narrative on the form does not tell them what they need to know, reviewers may deny the home health benefit for that patient rather than looking at any other supporting documentation.  As you know, to help ensure that home health patients are indeed under a doctor’s care, Medicare now requires all home health patients to have seen their doctor (or NPP working under the doctor) 90 days before or 30 days after the home health start of care.  For further assurance, the doctor’s authorization of home health requires a short narrative from the doctor or NPP.  Medicare now reports that the three top problems with the face-to-face documentation are the description of how the doctor’s visit related to the home health diagnosis and plan of care, the description of skilled need, and the description of homebound status.  Medicare has even provided a list of the most common narrative statements that are causing patients to have their home health benefits denied.  Here we reveal the list of the most commonly denied statements and give examples closer to what Medicare needs.

Homebound Status

Homebound Status

Skilled Need

Skilled Need

 

Please offer Pulse Home Health Care to your patients.

2325 Severn Ave, Ste 5 Pulse Home Health CareMetairie LA 70001 Pulse Home Health Care(504) 831-7778

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