For Providers

Information for Physicians

Working with Options Home Health

We strive to provide our patients with the best possible care. Toward that end, we collaborate closely with doctors to ensure that we are clear about our patients’ treatment plans so they can recover successfully at home. We want to make sure that physicians, their patients and families understand what is required before care begins.

Below is important information for physicians who order home care for their patients.

Documentation Required by Medicare

Home Health Order. The patient’s physician must sign and date a home health order that indicates:

  • Specific areas of home health care needed (nursing, physical therapy, etc.)
  • Reason for home health care (diagnosis, illness, injury, decline in functioning, etc.)

Face-to-Face Encounter Note. The patient’s physician is required to determine and document the medical need for home health care. Medicare requires that the encounter be:

  • Performed 90 days prior to or 30 days after care begins
  • Performed by a physician or nonphysician practitioner
  • Related to the primary reason for home health care

A note must be submitted to show how the patient’s condition supports his or her homebound status and the need for skilled services.

Medicare Reimbursement

Options Home Health accepts Medicare reimbursement if the patient:

  • Is eligible for Medicare benefits
  • Is under the care of a physician who establishes and periodically reviews the plan of care
  • Requires skilled nursing or physical therapy on an intermittent basis
  • Requires services that are reasonable and necessary for treatment of the illness or injury
  • Is homebound, with leaving home being extremely taxing

Medicare covers part-time or intermittent skilled nursing services, physical, occupational and speech therapy services, medical social services and medical supplies when ordered as part of the physician’s care plan. Medicare home health services do not cover 24-hour at-home care, meals, personal care or homemaker services if not related to an approved plan of care.

Additional Insurance

Other types of insurance reimbursement are considered and accepted on a case-by-case basis. Options Home Health also accepts personal payment for care. Patients with financial liability will be notified in writing of any personal responsibility for payment at the time of admission and before service starts. Documents delineating charges and the patient’s responsibility for services are available upon request.