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Posted By Kelly on 09-06-2005, 14:21:00 in Oncology
Good morning list! Our doctor has just put a patient on hospice. It is not
the kind of hospice where it is life ending and where the patient is bed
ridden, etc. It is the kind of hospice that the patient can come and go
when he pleases, etc. A technicallity per the hospice provider. Does
anybody know how this is going to effect of payment for chemotherapy? I am in PA.



Kelly Reibman, CPC

Mariette Austin, PhDMD
Comments (7)
Posted By Kelly on 09-06-2005, 15:52:00
Cindy,

Thanks for the information. I always appreciate your wisdom and knowledge.

Kelly Reibman, CPC
Mariette Austin PhDMD
Posted By Cindy on 09-06-2005, 15:43:00
Kelly,

One definition of 'hospice' is to control symptoms and increase patient
comfort, without an attempt to cure the underlying disease. Generally,
when a patient accepts/enrolls in a hospice program, they are agreeing
to comfort care, but not for curative measures. If the chemotherapy is
administered to provide comfort or relief, it will probably be
reimbursed by the hospice. Otherwise, there may not be any payment.

Insurance plans and hospice policies vary widely - my recommendation is
to work with the hospice to determine coverage.


Medicare links include:



http://www.cms.hhs.gov/providers/hospiceps/



http://www.cms.hhs.gov/medicaid/services/hospice.asp



http://www.cms.hhs.gov/providers/hospiceps/hospiceadd.asp



Cindy

Cindy C. Parman, CPC, CPC-H, RCC

President, AAPC National Advisory Board

Coding Strategies, Inc.

Phone: 1.877.6.CODING

Fax: 770.445.0407

cindy.parman@codingstrategies.com


visit our website at: www.codingstrategies.com
Posted By Kelly on 09-06-2005, 15:32:00
Thank you for all the responses. I will be checking with the hospice. It
is not one that I'm familiar with in our area.


Kelly Reibman, CPC
Mariette Austin, PhDMD
Posted By Lisa on 09-06-2005, 15:26:00
We have an agreement with our hospice ... the physicians get the drug
regimens appoved BEFORE administering them to the patients, and then
hospice will pay. They definitely cover the paliative - and sometimes
even therapeutic! The key is knowing that the patient is in hospice, so
the pre-auth can be obtained.
Posted By Kelly on 09-06-2005, 14:44:00
This is what I'm trying to find out. I would imagine they would but I need
to contact them. I'm working on getting a contact #, etc. So in other
words, the bills would go directly to hospice even though he is not
technically terminal with only 6 months to live?

Kelly Reibman, CPC
Mariette Austin, PhDMD
Posted By Beth on 09-06-2005, 14:40:00
Is the hospice going to pay?

Beth Potratz, CPC-A
bethp@thecancercenter.com
Posted By Kelly on 09-06-2005, 14:35:00
Additional Information received: This patient was told through the hospice
that all palliative meds would be covered. Has anybody heard of this? I
just contacted Medicare and they stated if the palliative meds are related
to the terminal illness, then it will not be covered.
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