Dear People Who CONSTANTLY fax Health 485s

JZ_RN · Sep 3, 2012

I know sometimes it takes a while but sometimes they send the form 2 times one day, then again the next., etc. etc. Med records doesn't look at these, just forwards them to the nurse, and then I've got a sea of paperwork to sift through, looking at tiny blurry dates, trying to figure out what's a duplicate or not. Like I stated before though, these people receive a voucher for home care, they are only allowed ONE agency. So when I get one from 3 different companies, we can't sign any of them. The home care agencies need to check and see if the patient is trying to get more than they are allowed. I also get ones for cert periods when we didn't see the patient or they no-showed or cancelled appointments. We can't sign those. I always put a note on them and send them back, but they keep resending them anyways. Just wastes more time and makes it take waaaayyy longer. And I've done med lists and sent them to the HHAs and sometimes they don't change them the next time or even give us a complete med list. It takes me so much longer to sort that out too.

mnkj · Jan 19, 2013

Why do you all fax those forms day after day after day? I know they need done and I will work on them as quickly as I can but it will take longer to sort through and see what's been handled and what hasn't when there's 50 forms on my desk every morning and half of them are duplicates, which I have to search for the duplicates (often sent to other nurses without me knowing, so I find out it's already partway done or someone did something with them already and they need signatures or clarification or something). I often get several copies for one patient. I don't have time every day to do these forms because I see patients, yet the companies keep calling, keep faxing. Why won't they let me do it when I have time and stop making it harder by sending it over and over and over? I got the paperwork, I don't need a new copy of it tomorrow. What I need is less junk sent to me so I can do real work and stop sorting through 5 copies of the same thing. Any advice on how to get them to stop sending me the forms every day? Our office tells everyone it can take 7-14 days for forms to get processed. One day after the fax is sent doesn't mean you need to call me and fax me again and again. It makes it so much harder and wastes so much time.

I appreciate that you take the time to actually review the 485. I have to imagine that it is a very time consuming task, especially if you have not seen the patient since a recent inpatient stay and the medication profile may be quite different than the one you have on file. We send an updated medication profile to the certifying physician within 24 hours of the admission to home care. Our agency policy is that we have a signed 485 and face to face within 3 weeks of admission to home care. What suggestions might you have other than "be patient"? We can not bill without the signed documents. I am sincere in asking the question. I am really looking for a solution that would benefit both sides.

Tammie99 · Jul 30, 2016

If a 485 isn't signed on time and an agency bills on that episode, that is considered fraud. If it isn't signed on time I can't bill for it....if I do I go to jail. PERIOD I lost over 50k last year from doctors signing a day or two late. I am a small agency and 50K is a lot of money.

You get paid by the hour...what does it matter what you are doing...you still get a check.

When I don't get the signed orders back in time...I don't get a check...I'm out the cost of taking care of a patient for 60 days for free...this is devastating to a small agency. I'm sure if your office would send the first request back in a timely manner, you wouldn't be receiving second and third request.

lpnmwebb · Oct 1, 2016

As an LPN who works in the field and in the office of an HHA I can tell you why you are faxed repeatedly. 7-14 days to get a signed POC back is unacceptable. Most small HHA can't wait 2 weeks to bill a RAP. once the SOC (and oasis is completed) and one follow up visit is made, the agency can bill Medicare. Waiting another 10 days for your signature is holding up our billing.

MrChicagoRN, RN · Oct 2, 2016

This isn't electronic?

The agency I used to work for went electronic back at the end of the 20th century.

lpnmwebb · Oct 2, 2016

Yes. The first one goes electronically. When we don't get a response within a week, we call the docs office. Usually they say they never received it. Then we fax it. Sometimes this works. We don't fax them everyday though.

Libby1987 · Oct 2, 2016

Old thread and I can understand the perspective of busy medical practices but with the professional salaries as well as an incredible amount of support staff needed to meet Medicare's complicated reimbursement and the state's regulatory criteria due and being a smaller independent agency, we not only need them back signed to remain in compliance but to also make our proportionately large payroll.

Isabelle49 · Oct 2, 2016

JZ, as a former Director of Nursing at a Home Health company, I can tell you that without a signed 485 returned to the home health office, billing for services is a problem. Most agencies are not flush with money and are not able to provide essentially free services for weeks at a time and this is what happens when 485's are not signed and returned promptly.