Medicare Compliance & Reimbursement
Physicians Must Know Home Health CPO
Home health providers should not let the HHS Office of Inspector General scare 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 time, the more willing they may be to refer 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 says. The docs are spending so much time on these complicated patients, they may as well get paid for it, she notes. 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 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 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 who need to understand CPO.
Medicare Compliance & Reimbursement
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