Review all clinical documentation for compliance with Hospice documentation standards

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Hospice Comprehensive Review

Auditor Will:

  1. Review all new admissions for referral information, Notice of Election, Initial Nursing Assessment and Certification of Terminal Illness for documentation to support beneficiary qualification for the Medicare Hospice Benefit.
  2. Assign the appropriate terminal illness diagnosis and coding for comorbidities in accordance with ICD-10 Guidelines for Hospice.
  3. Review Monthly Visits Notes comparing services documented to the Plan of Care established by the IDG/IDT team and perform pre-billing audit.
  4. Review all recertification information for documentation to support continued hospice service into subsequent benefit periods.
Admission

Review of appropriate documentation from referring physician, initial assessment, and CTI.

Auditor will:

  • Review the Referral Documentation, Notice of Election, Initial Nursing Assessment, and the Certification of Terminal Illness for sufficient clinical documentation to support beneficiary qualification for the Medicare Hospice Benefit
  • Review the Comprehensive Assessment and Plan of Care for meeting CoP’s and development of a valid plan of treatment to meet CMS requirements.
  • Quarterly consultative review of agency/clinician treated findings with recommendations for improvement.
Coding
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Review & Billing
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Recertifications
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