Re: HHRG and medicare billing
I'm not all that familiar with the HHRG, but I believe I understand what you're saying. Our docs always add the therapy and/or HHA requests to their referrals, so we know when the RN goes out to do the SOC, that this pt will be/not be a PT/ST/OT candidate. Our therapy referrals are made within that 5 days window.
That said.. there ARE times, however, that as the nurse continues to see the pt, and she notices that the pt. is realy more feeble or weak than initially thought, she can still request therapy at a later date, too... in other words, it's not always set in stone that therapy can only be requested the first 5 days.... (although this is usually the case).
I have also heard that we might be getting away from the "lump sum" payment for services and going back to the previous version of "pay for service".. where the agency can bill for the exact services they provide... whether it's 3 visits a week or seven visits a week. I believe this is how it used to be some years ago... and I believe we're headed back to that agin in the near future.
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