At Spectrum Home Health Agency, we make the process of referring and monitoring the progress of your patients simple. Because we share your dedication to outstanding patient care, you can feel comfortable knowing that our team of nurses, therapists, and other healthcare providers will adhere to your treatment plan. We will contact you immediately with any changes in your patients’ condition.
Physician Care Plan Oversight
Care Plan Oversight (CPO) reimbursement allows physicians to bill Medicare for their time overseeing the treatment of home care patients. Physicians may bill for 30 minutes of care plan oversight a month, including medical decision making, review of charts and reports, and treatment plans. Laboratory review or study results that weren't ordered during a face-to-face encounter, phone calls to other health professionals involved in patient care, calling in prescriptions, and other items on the home care patient's behalf are also covered. Our team can assist you with coding and billing for CPO.
Face-to-Face Encounters
In accordance with the Patient Protection Affordable Care Act, the Centers for Medicare and Medicaid Services (CMS) have issued a regulation requiring patients referred to home health agencies to have a face-to-face encounter with the physician that certifies the home health plan of care 90 days prior to, or within 30 days of, the start of home health services. The primary reason for home health services must be addressed during this encounter and must be:
- Made by the physician responsible for certifying home health
- Related to the primary reason for which the patient requires home health services
- Made within 90 days prior to, or within 30 days of, the start of home health
The encounter must be documented on the home health plan of care, or an addendum to that plan of care. For questions about face-to-face documentation requirements, please contact our office.
What the Process Looks Like
The first step in referring a patient to us is to fill out the physician referral form. This form can be submitted online, or we can take the information over the phone. Once the information is received, we will begin the process of verifying the patient's insurance, assigning a case manager, and coordinating the visit. Feel free to call our office at (256) 539-4457 to speak directly with our staff.
When Your Patient is Hospitalized
Admitting patients to the hospital happens often. If your patient is admitted, all care is assumed by the hospital staff until discharge, but our clinical supervisor will call each day to stay informed on the patient’s status and expected date of discharge.
Upon discharge, hospital nursing staff will need to fax discharge paperwork to our office and Spectrum Home Health Agency staff will see the patient within 24-48 hours. Any new orders, therapies, or medications will be implemented upon receipt of your written discharge dictation and orders.
