Physicians/Referral

How to Refer a Patient to Home Nursing and Therapy Services

Download the Patient Home Health Referral Form here.

Q: Who can refer a patient to home care?

A: An M.D., D.O., or Podiatrist can refer a patient to home care.

Q: Can I refer a patient by calling the agency?

A: Yes.

Call the referral line at (210) 582-0182 or (210) 822-8807

We will need the following information:

• Name, address, and phone number
• Social Security number and Date of Birth
• Health Insurance Information
• Emergency Contact Information
• Name of ordering physician
• Primary reason for home health

Q: Can I fax a referral?

A: Yes.

A referral can be faxed to the Home Nursing and Therapy Services by completing the referral form and faxing it to (210) 822-8863. If you have questions do not hesitate to call (210)822-8807.

Face-to-Face Encounter Physician Guidance/Care Plan Oversight

Due to the requirements in accordance with the Affordable Care Act, CMS issued a final regulation that requires a home health patient to have a Face-to-Face encounter with the physician that orders or refers Medicare home health services.

What is an encounter?

• The face-to-face encounter is an in-person visit that occurs between the certifying physician or collaborative non-physician practitioner (nurse practitioner, clinical nurse specialist or a supervised physician’s assistant) and the patient home health services are being ordered.
• The encounter MUST be related to the need for home health services.

When does an encounter have to take place?

The face-to-face encounter MUST occur:

• 90 days prior to the start date of home health services OR
• Within 30 days after home health has started services.

What documentation is required?

• Date of face-to-face encounter
• Medical condition which justifies primary reason for home health
• Clinical findings of the encounter that support home health need
• Clinical findings of the encounter that support homebound status of patient
• Physician signature AND date

Did you know that Care Plan Oversight (CPO) reimbursement allows physicians to bill Medicare for their time overseeing the care of home care patients?

You may bill for 30 minutes of care plan oversight a month, including medical decision making, review of charts, reports, or treatment plans; review of lab or study results that weren’t ordered during or associated with a face-to-face encounter; phone calls to other health professionals involved in the care of the patient, phoning in prescriptions, and other items on the home care patient’s behalf. Code for care plan oversight is: G0181 for home health.

Home Nursing and Therapy Services participates with the following insurance companies:

• Medicare
• Bravo (Medicare Replacement)
• Humana Military (Tricare)
• Sterling/Fresenius (Medicare Replacement)
• Universal Healthcare (Medicare Replacement)
• Care Improvement Plus (Medicare Replacement)
• Superior Advantage (Medicare Replacement)
• Unicare PFFS
• Pyramid/Today’s Options
• Humana (HMO’s and Medicare Replacement)
• Blue Cross/Blue Shield (HMO and PFFS)
• Traditional Medicaid
• Superior Health Care (Medicaid HMO)
• Amerigroup (Medicaid HMO)
• Molina (Medicaid HMO and Medicare Replacement)
• Secure Horizons
• Advantra Freedom
• Aetna PFFS
• Health Net Pearl
• And many more!