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Comments for "Hospice: Serving the Whole Unit—Patient, Family, Friends and Physicians"

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6 Responses to “Hospice: Serving the Whole Unit—Patient, Family, Friends and Physicians”
  1. sonali Says:

    I didn't know that you could still see your regular physician with hospice. I have an uncle with cancer and I have been researching various options for his future care. I'm glad to know we can keep his primary physician whom he has known for decades should we need hospice care.

  2. molyn Says:

    This may sound like a really weird question, but does the primary physician still get reimbursed from insurance or does the family have to do private pay to keep them on-board? It sounds like it's the choice of the family and the patient so it might not qualify as a cost covered by insurance.

  3. April Smith Says:

    Sonali,

    I was quite pleased to read this response and know that I am providing useful information to those who need it. It made me smile. Thanks for sharing.

  4. Lori Says:

    Molyn,

    That's a great question. Hospice providers have their own medical directors that work with primary care physicians to perform any functions the physician cannot, i.e.: house calls, emergency visits, etc. Medicare does not reimburse physicians for phone time, but they do reimburse for care plan oversight. Medicare has a list of requirements for what qualifies as billable care plan oversight. You can read those requirements here:

    http://www.aafp.org/fpm/20050500/23howt.html

    If you deal with a private insurance company, you may need to call them directly to see what their policies are.

    I hope this information helps.

    Lori

  5. April Smith Says:

    Molyn,

    This is a complicated question to answer. A lot depends on the individual hospice and a number of other factors. Non-profit and for-profit hospices have different rules and regulations. Some hospices may not allow you to keep your primary physician so it is good to research a hospice before the admission process. In cases where the primary physician is NOT the hospice Medical Director, the primary physician continues to bill Medicare.

    April

  6. Georgia Says:

    I am unaware of different rules and regualtions with non-profit vs for profit when it comes to Medicare. An Attending Physician or primary Physician may bill Medicare for Hospice intial assessment and oversight of care plan. Then when visits are made to the attending it depends on if the reason for the visit is related to the hospice diagnosis. If related and approved by the hospice then bill is forwarded to the hospice. If it is non-related to the hospice disgnosis then Medicare "B" is billed. It does not matter whether the hospice is non-profit or for profit. Medicare rules are the same. That is why it is so important that the patient, family and hospice have good lines of communications.

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