Hello April,
When a patient has both VA and Medicare, I believe it is the patient’s choice as to which plan they want to bill through. So, even though this patient has a skilled need for home care, but because he insisted on billing the VA, that is
allowable. I know it would be better to bill Medicare.
Medicare does allow Home Care while a patient is in Hospice, as long as home care is in there for services that are unrelated to the patient’s hospice care. You would bill Home Care with a condition code 07, including the NOA.
In the case you shared, my thought is that you would be fine to bill home care under the VA as long as it is not related to his Hospice stay under Medicare. If the patient was willing to have his unrelated home care billed under Medicare
that should be ok too.
Marnie
BTW – I have this NGS News Alert from last year, this is all I have on the subject of billing for home care and hospice at the same time under Medicare.
From: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Hanson,April
Sent: Friday, July 01, 2022 11:27 AM
To: billers@list.mnhomecare.org
Cc: Flatau,Jennifer <Jennifer.Flatau@PerhamHealth.org>
Subject: Billing question
|
**External Sender**
|
Good morning,
We have a patient on their VA benefit through home care for wound care. The patient's family asked that they be admitted under their VA benefit. Hospice is now involved and they are billing Medicare.
The patient would like to continue receiving home care services for their wound care. But being they are meeting a skilled need I really feel that they should have been admitted under Medicare. And home care and hospice couldn't both be billing Medicare. What
is the right thing to do in this scenario? Could the patient stay on home care under their VA benefit like the family is requesting while receiving hospice care under Medicare? Thanks!
April Hanson
Patient Accounts
Ph: 218.347.1894
F: 218.347.1885
Dedicated to health and wellness throughout life.
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