Home Health | Billing
GUIDELINES FOR MEDICARE BENEFITS IN HOMECARE*
Medicare pays 100% for home care services if:
1. You are homebound- If because of your illness or injury it takes a considerable taxing effort for you to leave your home and your absences are infrequent or of relatively short duration. You can still be considered homebound if you leave home to attend a religious service; to receive healthcare treatment, or to attend unique infrequent special events (family reunion, funeral, graduation, etc.).
2. You are an eligible Medicare beneficiary and under the care of a doctor who has ordered the treatment. This care must be reasonable and medically necessary.
3. You require skilled care that can only be provided by a licensed health professional. These health professionals include physical and occupational therapists, and speech language pathologists
4. You need care on an intermittent basis. Professional staff will visit in your home to provide assessment, treatment and teaching. The visit is for the length of time it takes to provide the specific treatment ordered by your doctor. Medicare does not pay for the health care staff to stay with you for an extended period of time.
Medicare will send you an Explanation of Benefits (EOB). This is not a bill. The EOB details the charges for your home care services and Medicare’s payment to the Complete Physical Therapy.
Realizing that insurance information can change, let us know right away if you have any other insurance or have chosen a managed Medicare insurance, so that we can update our records. Please call 301-699-1580 and to speak with a billing Coordinator.
Other Insurance
Every plan is different and your member services can help you to understand your benefits for home care physical therapy. We will check your coverage for you and file for your insurance claim. Most insurances will need authorization. We accept in and out of network benefits, liability claims, workers compensation and private payment.
* This is applicable to Medicare Home Health Services only.
