What to Expect at Intake –What is a referral?

A compliant intake process for a home health agency should include the following steps:

Patient Referral: Definition –

Orders from a physician, ARNP or PA for home health services. Ensure that the orders include necessary medical documentation, patient diagnosis, and required services.

If you do not get the necessary information from your patient liaison, marketer et al then stop this process to save yourself the headache of chasing this necessary information at a later day.

Gone are the days of “eval and treat.”  The face-to-face requirement made this type of referral non-compliant.

Do not credit your referral personnel with a referral until all the listed info is brought to your agency.

A name and an address are NOT SUFFICIENT.

If you did a forensic check into your claims that gave you trouble it is almost a guarantee that the intake/referral was insufficient.

Once the referral is at your agency, you should have a qualified person(s) that reviews the information and checks the insurance to be sure the patient meets the requirements for consideration of Home Health care.

The requirements for Home Health ** (at a minimum) are:

1. Being considered “homebound.”

2. Needing intermittent care from skilled professionals.

3. Having your plan of care ordered and supervised by a doctor.

**Not all private insurances require the above.

If you follow the above, and set a firm standard, with your marketing personnel, you will see a positive change in the efficiency of your care and compliance.

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