Medicare Home Health Reporting Requirements for Certifying Physician and Physician who signs the Plan of Care for episodes that begin on or after July 1, 2014

Available in the Main Office software with Version 5485:  Additional fields have been added to the Edit PPS Billing information screen in PPS Billing to meet the Medicare Home Health reporting requirements for episodes beginning on or after July 1, 2014.  The “Physician in OASIS” field is now available and will auto populate with the Physician from the OASIS.  The Document Review box will display the name of the physician on the Plan of Care.  This should match the Physician in the OASIS.  This Physician will report in claims as the Physician who signs the Plan of Care.  The Face to Face Physician (if different) field is also now available to enter the name of the Physician who completed the Face to Face Encounter documentation and certified the Patient for Home Health Services.  If the Face to Face Physician is different than the Physician who signed the Plan of Care – the Face to Face Physician will report in the claims as the certifying/re-certifying Physician.  The Document Review box will also display the name of the Physician on the Face to Face Encounter.  If the certifying/re-certifying physician and the physician who signs the plan of care is the same, only the Physician who signed the Plan of Care will be reported in claims.  Reminder:  All Physicians will need their NPI number entered in the software in the Doctors database.

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