Continuous Care

[toomuchbaloney]

I thought that it was illegal to misrepresent level of care when billing medicare? I could be wrong, but I was under the impression that companies that provide CC at EOL even when symptoms were under control was considered incitement and a big no-no.

It is not fraud to provide a higher level of care than is necessary without billing the insurer or the family. It would be fraud to provide a lower level of care while billing for something more involved and expensive. One is a gift and the other is lie.

[lifelearningrn, BSN, RN]

It is not fraud to provide a higher level of care than is necessary without billing the insurer or the family. It would be fraud to provide a lower level of care while billing for something more involved and expensive. One is a gift and the other is lie.

Is it not misrepresenting the level of care being provided? I'm not saying it isn't nice to provide extra care to a family, but providing CC and billing for routine care is essentially lying on legal documents.

[toomuchbaloney]

Is it not misrepresenting the level of care being provided? I'm not saying it isn't nice to provide extra care to a family, but providing CC and billing for routine care is essentially lying on legal documents.

Providing a higher level of hospice support for families during the active phase of the death without stressing to make certain that it meets criteria of continuous care (in staff mix and documentation, etc) is not lying to anyone. It is providing the care that the hospice agency and their staff believe would be most beneficial to the family without putting the reimbursement first in the equation, IMHO.