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At the same time that an agency is considering staffing, it also has to think about eligibility. We strive to process referrals quickly and thoroughly so that we can reach out to your patient to begin care as soon as possible. Instead of just knowing the hospital's name, doctor’s office, or medical center, you could get to know the person who is making the referral. By nurturing personal relationships, you’ll receive many more referrals in the future and demonstrate to the person that you're a trustworthy resource.
For a full listing of these services, please refer to your Evidence of Coverage - you can find it on your online member account at Ambetter.HomeStateHealth.com. November is National Home Care & Hospice Month, and CareAcademy honors the contributions of direct care workers and the value they bring to their clients and families. These heroic caregivers play a central role in our healthcare system and in homes across the nation. Whichever types of referral source you choose to build your home care agency, they all boil down to one thing, and that’s building relationships.
Becoming a Health Home care coordination organization
It is important that patients released from your agency’s care are positioned to avoid hospital admissions for potentially preventable conditions within the first 30 days of release. A competent, confident team will give consistent attention to high-quality care. They’ll make good decisions and score good outcomes for your home health agency. It’s clear that home-based care is experiencing a growth phase.
That’s certainly no secret to agency executives looking to take advantage of the boom. But to successfully capture more home health referrals and benefit from this growth, providing superior care in the home is essential. A written order from your primary care doctor for you to see a specialist or get certain medical services. In many Health Maintenance Organizations , you need to get a referral before you can get medical care from anyone except your primary care doctor. If you don’t get a referral first, the plan may not pay for the services. To see if a service requires authorization, check with your Primary Care Provider , the ordering provider or Member Services.
Referrals
For Medicare claims, you already track care quality and report it to the Centers for Medicare and Medicaid Services . Those quality ratings appear on Medicare’s Care Compare website and inform prospective clients how well you’re achieving positive outcomes. Once again, training and experience will better-ensure success for your team, as well as your clients. Your team must educate patients and family caregivers with clear instructions on medications and ways for patients to become more independent in their own activities. Staff training will ensure your staff is observant, can identify risks, and will promptly communicate problems to the patient’s physician. If the referral source is a managed-care or Medicare Advantage plan, the home health agency must verify eligibility through a prior authorization process.
But only half of palliative care programs in the country are affiliated with hospice companies, which means there’s another 50% up for grabs. Facility discharge planners have to ensure that their patients don’t end up back in the hospital in less than 30 days, or else they’ll get penalized. If you’re looking to stand out from the crowd and earn more referrals, then you’ll want to cultivate relationships with your local hospital discharge planners. Bear in mind that your rating depends on accurate documentation of your initial assessment of the patient and in your Medicare claims for the care provided.
Other Options for Making a Referral to HHUNY
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However, unlike a financial service arrangement, these won’t be mutually exclusive. Take the time to establish an exclusive arrangement with local financial and estate planning professionals who can refer clients. These arrangements are usually ten to twenty times more profitable than an average hospital referral.
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A safe and timely admission to in-home care for them starts by making referrals easy for you. Non-competing medical services can set up strategic partnerships that benefit both parties. For example, fall detection devices complement home care services. There are typically two forms of caregiver funding for America’s veterans from which home care agencies can get referrals. Make sure you promote your home care services by networking with local doctors and pharmacists in your community. Reach out to satisfied clients and ask if they know of any other people who could benefit from the services you provide.
When you do have a great track record, you will want to find ways to capitalize on your successes and expand your client base. All the work you’ve done to raise your scores will set you up to be an attractive referral option for hospitals, health systems, skilled nursing facilities, and other referral sources. What you can control, however, is your team’s training and attention to the process and outcome measures for home health.
Relias is committed to helping your organization get better through training, performance, and talent solutions that address your specific areas of focus. The Health Home program is a partnership between HCA, the Centers for Medicare and Medicaid Services and the Department of Social and Health Services .
That means making sure they are compliant with all required training, are up to date on evidence-based practices, and have the knowledge and skills to consistently provide high-quality care. When reviewing a referral for acceptance, home health agencies know that they must complete the comprehensive assessment within 48 hours of referral and submit the Notice Of Admission within five calendar days. Without complete medical records can slow down admission and billing processes. Furthermore, clinicians may have inaccurate or incomplete documentation without the whole story. Third party organizations that help veterans access the benefit usually contract directly with caregiver companies.
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