QUALIFYING FOR HOSPICE BENEFITS
To qualify for the Hospice benefit, patients must:
- Be eligible for Medicare Part A
- Be certified as having a terminal illness with a six month or less life expectancy
- Receive care from a Medicare-approved Hospice program
- Execute a statement electing the Hospice benefit and waiving all rights to Medicare payments for services related to treatment of the terminal illness
Certification that the patient is terminally ill must be placed into the patient’s medical record from both the Hospice Medical Director, or group member, and the patient’s attending physician, for the first 90- day period of coverage. Continued care for one additional 90-day period and unlimited 60-day periods can take place with required face-to-face encounters and appropriate documentation/certification of continued need for Hospice services.
While the largest amount of Hospice care is provided in the home setting,Hospice services can also be provided in nursing facilities, hospitals, specialized Hospice settings and assisted living facilities. Hospice services are paid for with a daily rate under four different levels of care based on the location and intensity of services provided. These levels are:
- Routine Home Care
- Continuous Home Care
- Inpatient Respite Care
- General Inpatient Care
With the ever-changing health care industry and the need to treat patients in the appropriate venue of care, Hospice care will play an important role in an organization’s healthcare service delivery system.
Let our hospice consultants help you to navigate the ever-changing healthcare industry to ensure that your patients get the care that they deserve.