Core Services
Nursing services, medical social services, and counseling are core hospice services and must routinely be provided directly by hospice employees. Supplemental services may be contracted in order to meet unusual staffing needs that cannot be anticipated and that occur so infrequently it would not be practical to hire additional staff to fill these needs.
Other services may be provided under arrangement. Arrangements made by a hospice to furnish items or services must be such that receipt of payment by the hospice for the services relieves the beneficiary of liability or any other persons to pay for the services. Whether the services and items are furnished by the hospice itself or by another organization under arrangements made by the hospice, both must agree not to charge the patient for covered services and items and must agree to return money incorrectly collected.
The arrangement agreement includes at least the following:
1. Identification of the services to be provided;
2. A stipulation that services may be provided only with the express authorization of the hospice;
3. The manner in which the contracted services are coordinated, supervised, and evaluated by the hospice;
4. The delineation of the role(s) of the hospice and the contractors in the admission process, patient/family assessment, and the interdisciplinary group care conferences;
5. Requirements for documenting that services are furnished in accordance with the agreement; and
6. The qualifications of the personnel providing the services.
The hospice must maintain professional, financial and administrative responsibility for the services and assure that all staff meet the regulatory qualification requirements.
Medicare hospice benefit. How to identify and handling the denial. Usage of correct CPT code and Modifiers. Using correct form,ICD code
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