decisionhealth Newsletters, Answer Books - 2006 Issue 7 (July)
Medicare_Benefit_Policy_Manual / Chapter_9 / 20.1
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Article Overview
This Medicare hospice policy article addresses the timing, content, and documentation standards for certification of terminal illness in hospice care. It is relevant to hospice providers, physicians, nurse practitioners, and billing staff who need to understand the administrative requirements that apply before claims are submitted. The guidance focuses on certification timing across benefit periods, written record requirements, and the parties involved in certifying hospice eligibility.
Why This Topic Matters
Hospice payment depends on meeting certification and documentation requirements, so understanding this policy helps providers support compliant claim submission and avoid payment denials for missing or untimely certification.
Article Sections
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Timing and Content of Certification
Covers Medicare hospice certification timing, the parties involved in certification, and general documentation expectations across the initial and subsequent certification periods.
What You Will Learn
- How Medicare hospice certification timing is structured for the initial and later certification periods
- What types of documentation must be maintained in the hospice record before claim submission
- Which provider roles may participate in hospice certification
- What general content the written certification must include
- How certification requirements apply when a beneficiary re-enters hospice care
Who Should Read This
- Hospice providers
- Physicians
- Nurse practitioners
- Hospice billing staff
- Compliance staff
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