Medicare and Home Health

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]I have scoured the internet looking for an answer as to how this process works. I can't seem to find an answer. I have to ] describe the billing process and the process for reimbursement for both Medicare clients and those home health patients with third party insurers. I am unable to find an answer to this question. Does anyone out there know the answer to these two processes involving home health patients? Thanks so much!

Specializes in Cardiac, Rehab.

What do you want to know? Home health agencies bill either medicare or the insurance company for x visits based on the diagnosis and dr's orders. The insurance company bases its reimbursements to a great degree on what medicare normally pays. There are lots of rules and regulations about number of visits, time spent in the house, etc. It gets more complicated and restrictive every year. And medicare reimburses less while the providers charge more.

The reason I know about this is primarily second hand, my wife has been in the home health biz for the last 20 years, and I've heard it all may times over. I would think you can google medicare reimbursement and get going from there if you want specific information, its all public.

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