- Inadequate Documentation of Terminal Illness: Hospice services are generally provided to individuals with a terminal illness. Insufficient documentation proving the patient’s terminal status or prognosis may lead to denials.
- Lack of Face-to-Face Encounter: Some hospice services require a face-to-face encounter between the attending physician and the patient to determine the eligibility and need for hospice care. Failure to document this encounter may result in denials.
- Inaccurate Length-of-Stay Determinations: Hospice services are typically provided based on the patient’s prognosis, and some denials may occur if there are discrepancies in the length-of-stay determinations.
- Documentation of Hospice Eligibility Criteria: Ensuring that the patient meets the specific eligibility criteria for hospice care is crucial. Inaccurate or insufficient documentation of eligibility can lead to denials.
- Failure to Meet Continuous Care Criteria: Hospice providers may offer continuous care during periods of crisis. Denials can occur if the documentation does not support the need for continuous care during these critical periods.
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Fundamentals of Hospice$285.00 -
Hospice Determination of Terminal Illness Quick Glance Tool$50.00 – $75.00 -
Policy & Procedure Manual$2,500.00 -
Hospice Coding and Documentation Tips Cheat Sheet$35.00 -
Face-to-Face Encounters – Hospice Cheat Sheet$40.00
