Guest guest Posted August 25, 2000 Report Share Posted August 25, 2000 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 > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 26, 2000 Report Share Posted August 26, 2000 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 ----------------------------------------------- FREE! The World's Best Email Address @email.com Reserve your name now at http://www.email.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 26, 2000 Report Share Posted August 26, 2000 > 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 27, 2000 Report Share Posted August 27, 2000 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 Quote Link to comment Share on other sites More sharing options...
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