cbr 004 hospice services an overview
TRANSCRIPT
CBR 004 Hospice ServicesAn Overview
One PI CBR Overview SGS Confidential – Page 1
March 2011
Confidential Information: Use or disclosure of the data contained in this sheet is subject to restrictions of the applicable task orders for SafeGuard Services LLC.
Hospice Facts and Statistics Hospice Requirements Non-Covered Services Continuous Home Care CBR Overview Frequently Asked Questions
One PI CBR Overview
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SGS Confidential – Page 2
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•1984 - January 2010: Hospices participating in Medicare rose from 31 to 3,407
•A Nearly 110-fold increase
Eligible for Part A; Terminal illness w/prognosis < 6 months Care from approved hospice Signed a statement indicating:◦ Elected the hospice benefit◦ Waives all other rights to payments for services
for the terminal illness
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Only during a period of crisis.◦ Nursing care to achieve palliation or management
of acute medical symptoms.
A minimum of eight hours of care◦ During 24-hour day◦ Beginning and ending at midnight.
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Nursing care provided by a RN or LPN.
Not intended to be used as respite care.
Billed in 15 minute increments.◦ Conversion to hours on the CBR
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Dates of Service: 1/1/2009 – 12/31/2009◦ Processed by 7/2010◦ Drawn from NCH
Four Hospice Care Settings:◦ Home Q5001, Q5002◦ Skilled Nursing Facility Q5003, Q5004◦ Freestanding Q5006◦ Inpatient Q5005, Q5007, Q5008
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Revenue Code 0651◦ Routine Home Care
Revenue Code 0652◦ Continuous Home Care
Revenue Code 0655◦ Inpatient Respite Care
Revenue Code 0656◦ General Inpatient Care
Compared to the average of CMS Region & national peers
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Q: I have specific questions about my claims. A: Ask your MAC/FI Q: The address on the letter is no longer
current; can you correct your files? A: Call the CBR Disseminator.◦ 1-888-313-9666
Q: I did not receive a comparative billing report. Would I be able to sign up to receive one?
A: Not at this time Q: Can I suggest a topic to study? A: Please do!
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Q&A
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Confidential Information: Use or disclosure of the data contained in this sheet is subject to restrictions of the applicable task orders for SafeGuard Services LLC.