Referrals
 

Anyone can make a referral for home health services.

How to make a referral to AFFINITY HOME HEALTH CARE:

  • Prior to making the service request to AHHC, please have the following information available:
  • MD's name that will be signing orders for service
  • Patient specific information
    Patient identifying information that will include at least, name, address, phone number, insurance that will be billed for the service, etc.
    Patient's functional limitations that restrict their ability to travel to MD's or clinics to access care
  • Detailed instructions for the services needed
    Disciplines needed (skilled nursing, physical therapy, speech language pathology, occupational therapy, home health aide in conjunction with professional service)
    Specific procedures for the skilled service
    All pertinent diagnoses including the primary problem requiring the skilled service
  • Start of care date
  • Other suppliers that will be providing supplies or services to the patient
  • When the above information has been obtained, call AHHC @ (713) 947-2277 our preferred time for accepting referral requests is Monday through Friday between 8:30AM and 5:00 PM.
    **Sometimes it is easier to communicate prescribed medications or procedures by faxing the documentation to AHHC @ (713) 947-2292.
  • Once you have successfully made your first referral to AHHC, you can fax subsequent referrals to AHHC @t (713) 947-2292, and we will telephone you with any additional questions about the referral.
  • The first visit will occur within 24 hours of receiving the referral or as otherwise requested by the patient or physician.
  • If the referral source is not a physician, the admitting clinician will call the physician's office for verbal orders in order to commence care.
  • If you have questions, please feel free to phone us @ (713) 947-7777
  • Affinity's Crazy Egg Hunt

 

 

 

 

FAQ'S

All patients of Affinity Home Health Care must have a physician directing the care for an acute condition or exacerbation of an existing condition.

PHYSICIAN OVERSITE CARE:

Since 1995, physicians that oversee the complex care needs of Medicare home health patients can be reimbursed for these services. In addition, since 2001, physicians can also bill for the services associated with certifying and recertifying home health services for their Medicare patients.

Physician Care Plan Oversight is defined as physician supervision of a patient (patient not present) under the care of a Medicare Certified Home Health Agency (HCPCS CODE G0181) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patient status, review of related laboratory and other studies, communication (including telephone calls) with other health care professionals involved in patient'' care, integration of new information into the medical treatment plan and/or adjustment of medical therapy, within a calendar month; 30 minutes or more.

To receive payment the physician:

  • Must provide service to Medicare beneficiaries receiving covered home health/hospice services;

  • Must have had a face to face encounter with the patient in the six months prior to the first billing for care plan oversight services; and

  • May not have a relationship with the home health agency that is prohibited by the Stark II (Physician Self-Referral) regulation.

Please be aware that surgeons may bill for post-surgical care plan oversight if documentation shows the care is unrelated to the surgery.

Medicare requires the physician to document the services that were furnished, the date, and the length of time associated with those services. Affinity Home Health Care has listed an editable and printable Physician Oversight Billing form to assist you in keeping track of this information. This form is for your personal billing use and does not need to be returned to Affinity Home Health Care. We send this form to the primary physician for each of our Medicare patients along with the Home Health Plans of Care for review and signature.

Certification And Re-Certification Services:

Physician Certification of Home Health Plan of Care (HCPCS Code G0180) is defined as physician services for initial certification of Medicare-covered home health services, billable once for a patient's home health certification period. This code will be used when the patient has not received Medicare-covered home health services for at least 60 days.

Physician Re-certification of Home Health Plan of Care (HCPCS Code G0179) is defined as physician services for recertification of Medicare covered home health services, billable once for a patient's home health certification period. This code would be used after a patient has received services for at least 60 days (or one certification period) when the physician signs the certification after the initial certification period.

We recommend that physicians retain a copy of the signed HCFA-485 (home health plan of care), signed interim or telephone orders, or any other documentation that would support provision of these services.

Billing Notes: Physicians bill for Care Plan Oversight or certification/recertification using Form HCFA 1500. The claim for these services must contain the home health agency's 6-digit Medicare provider number (Affinity Home Health Care's Medicare Provider Number is 679442) . The dates of service should be the date the physician provided the service, not the Medicare beneficiary's dates of services. Specifically, the dates of service on the HCFA 1500 should be:

  • Care Plan Oversight: FROM the date of the first CPO service provided in the calendar month TO the date of the last CPO service provided in the calendar month.
  • Certification/Recertification: The date the physician signs the plan of care.

Medicare requires the physician to document the services that were furnished, the date, and the length of time associated with those services. Affinity Home Health Care has listed an editable and printable Physician Oversight Billing form to assist you in keeping track of this information. This form is for your personal billing use and does not need to be returned to Affinity Home Health Care. We send this form to the primary physician for each of our Medicare patients along with the Home Health Plans of Care for review and signature.