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Discussion

Questionable employer

So home care services have many specifications under Medicare. One is that visits must be 45min long to bill and multiple disciplines on the same case must have visits at least 5 min apart. I showed up to a visit today, sat in the car for almost 10 min to eat my lunch, then went in and marked my actual start time. DON is asking me to change my log because PT used an end time matching my start time. I did not see the PT present while I was sitting out front. Am I causing an unnecessary ruckus in telling her that this is fraudulent and that I'm not comfortable changing my time when I didn't even see her there?

What they keep telling me is that we have to have "45 paper minutes" aka 45min on our time logs per visit. I argued that it's 45min with the patient, not paper minutes. I've been told several times that it doesn't matter how long I'm in the home, my time log must show at least 45min.

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    • Expert

    Sounds to me like your employer has an issue with the other provider, not you. Stand by your ground to put actual times in and out on your paperwork. You have no responsibility for what the other person puts on their​ paperwork. However, a 5 minute actual visit is not going to be reimbursred, so you need to find some way to see that your visit is at least 45 minutes.

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    • Author

    Thank you!

    My visits are almost always 45-60 minutes, because if they need home care, their needs should take about 45 minutes if the provider is thorough.

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    Is this a recent regulation change? Just asking because I worked for a reputable home care agency for several years and never heard of this. My visits occasionally were less than 45 minutes and different disciplines had overlapping times often. If the visits occurred together we were instructed to document that it was a joint visit.

    I considered time spent documenting the visit as part of the visit time, and it was normal practice. Meaning if I completed the visit and parked nearby to finish charting, I would include that time in my visit time.

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    • Expert

    I had at least one visit that lasted two and a half hours because of the circumstances. I knew I was only going to get paid the set visit rate, but I also knew that I had to accomplish what I came there to do. I had no intention of "papering" the visit. It seemed that I got the "problem" clients that did not fit the "in 'n out" visit criteria, I didn't want to have to deal with being caught in the middle, so I left the intermittent visit arena. It is much less stressful to complete all of the documentation during the course of an eight or twelve hour shift with an extended care client and then to drive straight home.

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