decisionhealth Newsletters, Answer Books - 2008 Issue 12 (December)
Answer_Book / Hospice_Care / Ensure_payment_when_you_file_hospice_claims
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Article Overview
This article covers hospice billing guidance for Medicare Part B claims when a patient elects an attending physician, along with related claim-handling considerations for substitute physicians and non-terminal-condition services. It is aimed at clinicians, billing staff, and coders who need a practical overview of hospice claim submission requirements and the general circumstances in which specific billing designations are discussed. The article also notes a nursing practice scenario involving attendance and certification responsibilities within hospice care.
Why This Topic Matters
Hospice claims can be denied if they are not filed in a way that matches the patient’s hospice election, attending-provider status, and the relationship of services to the terminal condition. Understanding the article helps billing teams recognize when hospice-related claims involve coordination with the hospice, carrier notification, or physician coverage arrangements.
What You Will Learn
- How hospice billing is handled when a patient elects an attending physician
- Why hospice carrier notification is part of the claims process
- How physician coverage arrangements are discussed in hospice billing contexts
- How services unrelated to a hospice patient’s terminal condition are addressed
- What role nurse practitioners may have in hospice attendance and certification contexts
Who Should Read This
- Physicians
- Nurse practitioners
- Medical coders
- Billing staff
- Revenue cycle personnel
Modifiers Discussed
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