Home Health & Hospice Week

One HHA is making referral sources' lives easier - and more profitable.

Don't let the HHS Office of Inspector General scare your referral sources away from billing for home health care plan oversight.

Physicians can secure reimbursement for their home care and hospice-related supervision duties with the CPO billing codes G0181 and G0182. And the more they are compensated for their valuable time, the more willing they may be to refer more patients to home care services when appropriate.

Sutter VNA & Hospice, an eight-location provider-based agency based in Emeryville, CA, is putting its CPO knowledge to its marketing advantage with an education program for referring physicians.

Some physicians who didn't want to deal with the hassle of prescribing and working with home care for their patients have turned over a new leaf since learning they can bill for their time, says Paula Silver-Manno, director of business development for Sutter.

"This is a huge opportunity for [physicians] to bill" and secure compensation for activities many of them are performing anyway, Silver-Manno tells Eli. The docs are spending so much time on these complicated patients, they may as well get paid for it, she notes.

What Sutter Does to Educate Docs

Sutter has a variety of techniques for educating referral sources on CPO billing. The agency mails out information packets, personally drops off information packets at physicians' offices, and schedules meetings with physicians and/or their billing staff to help them understand billing requirements and procedures, Silver-Manno explains.

The information packets include the basics on coverage and billing criteria in an easy-to-read format, she says. They include a question-and-answer segment helping physicians and their staff understand what is billable and what isn't.

Sutter targets for education both physicians who already refer large volumes of patients and those that the agency would like to develop into larger referral sources.

Biggest challenge: Convincing physicians to document the 30 minutes per month required for CPO billing is the biggest hurdle Sutter faces in encouraging the service. But "it's amazing how quickly 30 minutes adds up," Silver-Manno maintains.

Biggest help: To make documenting CPO as pain-free as possible, Sutter distributes a CPO worksheet/log to physicians. (For a copy of this log, go to www.suttervnaandhospice.org/doctors/doctors_cpo.html.)

Sutter advises office staff to put a copy of the CPO log in the patient's chart. Every time the physician performs a CPO-countable service for the patient, he'll most likely have the chart in front of him anyway. It will take only a minimum extra effort to record the activity and time related to the service in the accompanying worksheet.

"Assure physicians it won't take a ton of time" to document the services, Silver-Manno recommends. If you can talk them into just giving the documentation and billing a try, physicians will be much more apt to stick with it once processes and forms are in place to facilitate the activity.

Next up: Even with Sutter's educational ef-forts, only about 5 percent of referring physicians bill for CPO, Silver-Manno estimates. To work toward increasing that number, the agency next is putting together a CD-ROM with a quick overview of CPO billing requirements to deliver to physicians' offices around the holidays.

"It should be simple and quick" for the physician to read, Silver-Manno says. "Not more than 10 minutes."

Referring physicians that do bill for CPO have encountered little or no trouble obtaining payment from Medicare, Silver-Manno reports.