Home Health utilization review

Specialties Home Health

Published

I have a question regarding home health utilization. I'm fairly new to home healh and my company recently started using a new company for review. I am in a pickle now to where they want me to change the frequency that I see my patient. I recertify them for once a week for nine weeks and three PRN's. Physical therapy also sees the patient twice a week. The company wants to change my visit to one week three then once every other week. I reached out and told him I do not feel that this is appropriate for this patient particularly because they have unresolved hypotension, possibly post concussion syndrome, along with essential tremors. The patient is a high fall risk as well. After I reached out, they did not want to change their recommendation. So I told them that because I did not agree that I felt it was only appropriate that they submit the order for the change in frequency versus the order for my recertification frequency and I was not comfortable signing the recertification if they change the frequency. All in all said, I ruffled some feathers.
So I am just wondering am I the one who's wrong? It's my nursing license.  So IDK. 

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