Are you eligible?
Coverage for home care services is dependent on the insurance provider…Medicare, Medicaid, Private/Commercial insurance or self-pay. Every patient referral will be verified for insurance benefits and coverage, as well as inform patient or family prior to services rendered of any out of pocket costs.
Medicare requires the following criteria requirements be met to certify patients for home health services:
- Patient must be “home bound”, which means that if the patient leaves their home, absences need to be infrequent, short periods of time, but requiring medical care treatment, religious services/ceremonies, attending adult daycare or for unique infrequent events such as a funeral, graduation, and trip to barber or hairdresser.
- Patient would require periodic and intermittent care. the care required would not be continuous care throughout the day or required seven days a week.
- Care must be ordered through a physician’s order and under the direction of a physician.
- A plan of care will be established and will be periodically reviewed by a physician.
- A face-to-face encounter must be documented by the physician or allowed non-physician practitioner that the patient has seen.