To receive home health services, a patient must meet the following requirements - they must:
- Be confined to their home (homebound)
- Need skilled intermittent nursing, physical therapy, occupational therapy or speech language pathology services
- Be under the care of a physician
- Receive services under an established Plan of Care reviewed by a physician
- Have had a face-to-face encounter with a physician or qualified Non-physician Practitioner under the supervision of the certifying physician.
The physician providing the care supervision (in bold, above) is the following or certifying physician for the home health episode that is covered by the Plan of Care. This physician certifies that the patient is eligible for home health care, and establishes the home health Plan of Care for the patient.
In the Solution we use the terms "certifying" and "following" somewhat interchangeably. The critical distinction is that whereas the certifying physician will always be a following physician, there could be numerous physicians following a patient's course of care who have no connection with the required home health care certification.
The value of this table is that it allows us to bring focus on physicians with larger Medicare patient populations who are already certifying patients. We want to identify physicians who are committed to home care but who could certify more frequently and direct those patients to your home care agency. We can find physicians who are certifying a larger percentage of patients by sorting.
The columns in this table that are highlighted blue indicate metrics from claims where the physician was the certifying physician.
The first step is to sort the table by the column, Physician Followed Patients, This HHA. (Click on the header.)
This will bring the following physicians to the top:
At one level, the physicians sorted to the top of the table are probably the best prospects. Nevertheless, the best course of action is to use this search as a starting point to investigate these top prospects further. Right click on the physician's name in the table an open the link in another tab.