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Re: Outpatient services

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My understanding... if the resident is receiving home health for some reason

and that home health agency also offers therapy.. the home health agency

must provide the comprehensive services....

Steve Passmore

steve@...

Outpatient services

> I am looking for regulations regarding the provision of services by a

> hospital outpatient department for the following scenario:

>

> Hospital Outpatient Department providing PT/OT/SLP services to Assisted

> Living senior communities. These senior communities are apartment

complexes

> with a dining hall and 24 hour staff. Some of the residences are

indendent

> apartments and some are assisted living. They are not SNF's. There is a

> gym type area available to treat, but some treatments would be done in the

> patient's apartment for more privacy. They are billed as outpatients. Is

> there a conflict with home healthcare?

>

> Rehab Pro - The New Way...A Better Way to Rehab Success! Call for

details -.

> Rehab Management Solutions can solve your cash flow problems - (877)

552-2996

> Coming September 22,2000 - Helene Fearon on Coding and Reimbursement -

Rochester Michigan. Register at today.

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I do not see a potential conflict with home health care as much as the

hospital billing. Home care is billed the same way that outpatient services

are, but I believe hospital billing is different. Home care agencies also

have to have a Certificate of Need for the areas they serve. However I have

noticed that contract services provided directly to managed care payers are

handled exactly like outpatients. So, it may depend on the payer.

Caren

- Re: Outpatient services

My understanding... if the resident is receiving home health for some reason

and that home health agency also offers therapy.. the home health agency

must provide the comprehensive services....

Steve Passmore

steve@...

Outpatient services

> I am looking for regulations regarding the provision of services by a

> hospital outpatient department for the following scenario:

>

> Hospital Outpatient Department providing PT/OT/SLP services to Assisted

> Living senior communities. These senior communities are apartment

complexes

> with a dining hall and 24 hour staff. Some of the residences are

indendent

> apartments and some are assisted living. They are not SNF's. There is a

> gym type area available to treat, but some treatments would be done in the

> patient's apartment for more privacy. They are billed as outpatients. Is

> there a conflict with home healthcare?

>

> Rehab Pro - The New Way...A Better Way to Rehab Success! Call for

details -.

> Rehab Management Solutions can solve your cash flow problems - (877)

552-2996

> Coming September 22,2000 - Helene Fearon on Coding and Reimbursement -

Rochester Michigan. Register at today.

> How to Start a Private Practice with Dick Hillyer - 9/23-24, 2000 Register

at .

> Visit our EStore at www.RehabBusiness.com

>

>

Rehab Pro - The New Way...A Better Way to Rehab Success! Call for details

-.

Rehab Management Solutions can solve your cash flow problems - (877)

552-2996

Coming September 22,2000 - Helene Fearon on Coding and Reimbursement -

Rochester Michigan. Register at today.

How to Start a Private Practice with Dick Hillyer - 9/23-24, 2000 Register

at .

Visit our EStore at www.RehabBusiness.com

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> I am looking for regulations regarding the provision of services by a

> hospital outpatient department for the following scenario:

>

> Hospital Outpatient Department providing PT/OT/SLP services to Assisted

> Living senior communities. These senior communities are apartment

complexes

> with a dining hall and 24 hour staff. Some of the residences are

indendent

> apartments and some are assisted living. They are not SNF's. There is a

> gym type area available to treat, but some treatments would be done in the

> patient's apartment for more privacy. They are billed as outpatients. Is

> there a conflict with home healthcare?

Here in Florida, I work for a company that does both homehealth care (on a

contracted basis) and outpatient PT/OT/ST for ALF's. Homehealth PT is

billed

under Part A, outpatient under Part B. The outpatient services are provided

by

a CORF, which to my understanding can provide outpt services in pt's homes,

which is what an ALF is considered to be. If the pt is admitted under

Homehealth,

all of the guidelines must be met for " homebound " pts; when the pt goes off

HH,

we see him/her as an outpt under the CORF provider #. If the pt is

presently

receiving skilled nursing under HH, he/she can receive PT as an outpt; as of

Oct.,

I've been told, if HH skilled nursing is being provided, then the pt must

also

receive therapy under HH as well (which makes intuitive sense to me).

I can't provide you with the actual Regs; I'm just a flunky PT, not a

manager in

this organization. The co. I work for has non PT/therapy management, suits

who

are concerned with marketing and reimbursement issues. When I found out

how much $$ they make off the work of us " flunkies " vs how much we are

paid.....

well, that's better left to another time.

, PT

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Margaret --

Fortunately, you may find all of the appropriate regulations through

PTManager.com.

You may find that the only way that any Medicare provider may get

reimbursed for seeing a patient at their residence (wherever that may

be) is if they meet criteria for " Homebound " status. If they're seen at

some other place, like their apartment's gym/health club, there may be

an issue of whether that area physically qualifies as an appropriate

treatment area for the CORF in question.

These issues are very fluid. They change very frequently. The question

of " Provider Based Status " for treatment areas which are more than 750

feet from the MotherShip is still somewhat ambiguous, and has changed as

of the 1st of this month...

But, you're a professional, so it's appropriate to check for yourself,

just as if I came and told you that there is research to suggest that

Procedure A is effective on condition B.

It takes a lot of non-treatment time to stay on top of the non-clinical

aspects of being a professional these days. Remember that society has

decided to spend less on health care, yet will expect to receive more of

it. Isn't that an interesting dilemma? If you had a lot of money to

invest, and wanted to get the best return on it, would you invest it in

a healthcare entity, or in an internet.com stock?

That's the decision which is made every day by the owners of your

company. They can move their investment easily. If they chose instead

to buy Ford Motor Co. stock, your patients would lose. So would you.

For an organization or individual to try to get paid is not an ignoble

act. Perhaps it's a good idea to try to help your employer to thrive in

this hostile environment in which we live, or find one which you can

support. It isn't like it used to be, and life's too short to drink bad

wine...

Best wishes in your quest,

Dick Hillyer, PT

Cape Coral, FL

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