What is home health care
What is Home Health Care
Home Health Care is intermittent health care services provided by licensed providers. These services include Physical Therapy, Occupational Therapy, Speech Therapy, nursing services, home health aides and in some cases, IV therapy. These services must be ordered and overseen by a physician. These services are paid for by insurance. In the case of standard Medicare, providers must accept assignment. In other words, they must accept what Medicare pays as full payment. A provider should never ask you about a secondary insurance in this instance. In the case of Medicare Advantage Plans, some plans do have a per visit co-pay. Check the schedule of benefits to determine if that is the case.
Once a physician has written an order for Home Health, the agency who receives the order will call to get additional information. Many hospitals and rehabs will automatically select the agency for you. They should be giving you a list of three providers to choose from. If you want a particular agency, tell the Social Worker or Discharge Planner. MY PET PEEVE IS WHEN YOU ARE NOT GIVEN A CHOICE OR YOU ARE TOLD YOU HAVE TO USED A PARTICULAR PROVIDER. THIS IS AGAINST THE LAW. PATIENT CHOICE MUST BE HONORED.
Home Health services cannot begin as the same day of discharge from a hospital or rehab. Some agencies might do a “courtesy visit”, but they are not allowed to bill Medicare for that visit. Generally, a Registered Nurse will do the first visit and assessment, but it can also be a Physical Therapist. The assessment is called the OASIS (Outcome and Assessment Information Set) visit. This visit usually takes a couple of hours. All the questions they ask are required by Medicare or Insurance. The answers, once entered into the computer, generate what is called a Plan of Care. https://www.medicare.gov/what-medicare-covers/home-health-care/home-health-plan-of-care.html. The physician ordering services must sign off and accept this plan as well as follow up at 30 days. If PT,OT,ST services are necessary, a therapist for each modality will come do an assessment and determine the frequency of services.
The end goal of Home Health is to get a person stabilized and teach the senior and/or families how to manage chronic conditions. Home Health is not meant to be forever care. With that being said, it is not uncommon for individuals to be recertified for an additional 60 days if needed. Medicare does not pay for custodial type care, like feeding, dressing, medication management etc. If a home health aide is ordered, they are there to assist with bathing and dressing while therapists are working to get the patient back to being able to do these things safely.