Hi everyone. I used to work for a home care agency, but left several months ago for a new job. I received a call from the agency today regarding an audit on some charting I did on a patient I saw in March. His homebound status is being questioned. Agency wants me to come by the office and "bulk up" the documentation to support homebound status so they can get paid. I have a weird feeling about making changes to months-old documentation I did for an agency I no longer work for. Is what they're asking me to do right? I want to be helpful, but I don't want to do something that will come back to bite me. Thanks.
Nov 6, '17
HELL no it's not right. Your documentation has already been signed, accepted, sealed, and delivered!! My wife is a HH PT and was faced with similar circumstances years ago but she was still employed with the company. She resigned after they asked her to change documentation to fit the needs; that company is no longer in business. These companies know how strict Medicare is and stuff like this begs for a fraud investigation.
Nov 11, '17
Did the patient meet the criteria for homebound status? Did the provider certify the homebound status? The homebound status fulfills one aspect of qualification for homecare. The documentation of the physical assessment and skilled need serves to illustrate the validity of this status.If you failed to document the assessment verifying homebound status then it is your error and I would do a late entry and correct it.Why should the agency not get paid if they deserve payment.That's how I see it!
Nov 12, '17
Don't do it. If you truly made an error it should have been caught long ago by agency chart review. If their review process is lacking or absent that is not your problem. How can you even remember what happened? I can't remember patients from the start of my shift. Unless you were negligent, and you have full recall of the situation, I would not do this.
Nov 20, '17
No no, no! If CMS audits his chart and determines he was not homebound you are the one on the chopping block. You have no responsibility to a prior employer.
Nov 21, '17
No way! They should have known through case conference and daily phone meetings whether or not the patient was truly homebound. It is their problem. They only want you to do it so that they can get paid for that patient. You resigned. You're done. What they are asking you to do is wrong. You are no longer their employee so ethically it's wrong but it's also legally wrong due to HIPAA. It is their problem. Tell them NO!
Nov 21, '17
I don't think she would be responsible. The agency is responsible, she no longer works for them. She would be responsible if she goes back and re does the documentation.
Nov 22, '17
I won't speak to making a late entry but I will say that a few of these comments above dismiss your responsibility working in a licensed capacity. You were responsible to assess every patient for home bound status at every visit and to either provide supportive documentation or notify patient, MD and agency that patient was no longer home bound and to act accordingly.
Since you didn't say that the agency had unrealistic expectations during your time of employment, i.e. worked you into the ground, nor that the patient wasn't not homebound, perhaps you didn't document adequately and the agency is stuck with not being reimbursed for services provided.
As far as going back to document, don't rely on an internet forum for legal advice
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