Home Health & Hospice Week

Missing F2F elements will mean delayed, or denied, reimbursement.

If you’re not already crystal clear on face-to-face physician encounter requirements after the Probe & Educate review campaign, make sure you have them down pat before pre-claim review starts.

The Centers for Medicare & Medicaid Services specifies that the certifying physician and/or facility medical records must include the actual clinical note for the F2F encounter that demonstrates that the encounter:

1. Occurred within the required timeframe by including the visit date;
2. Was related to the primary reason the patient required home health services; and
3. Was performed by an allowed provider type.
The above three elements are the ones that the physician must document herself, experts stress. The home health agency can’t furnish that information.
The physician or facility medical records also must include information showing the patient’s:
4. Need for skilled services; and
5. Homebound status.