Dear People Who CONSTANTLY fax Health 485s - Page 2

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  1. Aug 29, '12 by
    These are patients receiving a community health voucher for home health care. They are not insured patients and not paying out of pocket. We have an underserved population and usually they can only get payment for 1 agency or they are only allowed a certain amount of hours with a nurse or hha. That's why we only sign one or two if they have hha with one and nurse with another. It's not like a normal clinic, we have uninsured people and they try to get more than they are allowed.
  2. Sep 2, '12 by
    The other consideration is that the patient is in danger of losing their home health services if there is no valid MD order for the cert period, signed in time. In my experience as a Case Manager who creates the 485's, some docs take a month or more to get it back to us, and in the mean time we are not in compliance with Medicare/Medicaid rules so we have to stop giving home care, or risk citation.

    As for the meds being incorrect, that is one reason we send our list, because we need an accurate list. Please send the accurate list back with the signed 485 and the corrections can be made.

    Yes, it's true that some people have more than one agency. For example our company does not do PCA's anymore due to reimbursement issues. But we can provide HHA, homemaker and nursing. But if the PCA agency says they are doing RN supervisor visits periodically, it may look like the client is getting nursing from 2 different agencies. But they are not--it's just a supervisor visit which is all about supervision of the PCA, not a real nurse visit. I hope that makes sense.

    I am glad you posted your frustrations, and are giving us the chance to respond. I think it helps everyone to have a better understanding of the other side's thoughts.
    JZ_RN and KelRN215 like this.
  3. Sep 3, '12 by
    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.
  4. Jan 19 by
    Quote from JZ_RN
    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.