For Skilled Care Many Payers require the agency to have a Document on File called a Face-to-Face Encounter.
Medicare traditional Fee for Service requires this document be on file, in order to bill for services.
It is Best Practice to obtain this document upfront during the Client Onboarding process.
The Face-to-Face Encounter between the Patient and a Physician, or an allowed NPP (non-physician practitioner), must have occurred prior to certifying a patient's eligibility for Homecare.
The face-to-face encounter must occur within the 90 days prior to the start of home health care, or within the first 30 days of the start of care.
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Patient Onboarding
The Best Recommended practice is to have the Face-to-Face requirement met upfront during the Intake of a new Home Health Referral. In Billiyo this Intake process is referred to as, Patient Onboarding. Billiyo has the ability to add the Face-to-Face document during the Patient Onboarding Process, where you can upload a PDF file that you have received from the Qualifying Physician and/or NPP at the time of creation of your new Patient Profile.
For Skilled care this would occur during Step 2 of the Patient Onboarding Process.
Once the User has entered the basic demographics in Step 1 of patient onboarding and selects Save and Next, the Physician is, by default, automatically selected as the First Contact Type that you will associate with the new Patient. A box will be available for the agency to either upload or drop and drag the file that you previously saved to your computer.
Add the Physician's name by beginning to type the first few letters of the Physician's last or first name into the Search Physician Box. Billiyo will automatically pull from suggested Providers by name matching to the National Provider Registry and display all potential name matches with the Provider's NPI number. Once you are satisfied that you have the correct Physician click on the Physician's Name and Billiyo will auto fill the rest of the information for you.
Then click into the Click or Drop and Drag Box, this will open your file options available for upload. These are the files that you have saved to your computer and once you are satisfied that you have chosen the correct file, you may now click Save and Next Button at the Bottom of your screen.
You will then continue your data entry until the process of Patient Onboarding is complete and you have gotten all the way through to Step 5 and the last Button available for you is Finish. Click the Finish Button to complete the Patient Onboarding.
If for some reason you do not have this Document up front and do not have the ability to add it at this stage of the Intake process, do not worry, you may continue to onboard your patient without it and you will have the option to add it later in the Face-to-Face Document Tab.
Patient Dashboard
Once you have successfully added the Face-to-Face Document or File the document now lives in the Patient Dashboard, where it can be viewed.
We will navigate to the document by going to CRM>Clients>Patient Dashboard
By default, the status of the Patient on this page is automatically set to active.
In skilled care a patient that has just been entered into the system is under the status of pre-admission.
You will need to change the status to Pre-Admission prior to searching your client in the search bar. Then Search for your Client and the system will take you to the Patient Dashboard.
Face to Face Tab
Here we can now view the PDF of our File that we uploaded in Step 2 of the Patient Onboarding process. We can also add a request for a Face-to-Face document by clicking on the Plus Sign, which we can fill out for the Physician or NPP and send to the Physician or NPP for signature or we can upload a new Face to Face File by clicking on the Cloud Icon.
Physician Contact
In order to associate a physician to a Face-to-Face document, Plan of Care or 485, the physician must be associated to a patient's chart.
A Patient may have multiple Physician's through the lifecycle of Home Health.
We can add a newly associated Physician to the Patient through the Patient Dashboard in the Contacts Tab.
Once a Contact Type of Physician is selected, a new box will appear to include Physician details such as NPI and License information. This will be automatically filled in once you have selected the Physician that you are associating to the Patient.
After selecting the contact type of Physician, go to the search New Physician Drop Down Field. Add the Physician's name by beginning to type the first few letters of the Physician's last or first name into the Search New Physician Box. Billiyo will automatically pull from suggested Providers by name matching to the National Provider Registry and it will display all potential name matches, click on the name from the list that you are associating to the Patient and Click on the Save Button.
The newly added Physician will now be available to choose from when you are sending a New Face to Face request.
To take this step, go to the Face to Face Tab in the Patient Dashboard, click the Plus sign, fill in the information, select the new Physician and Click Save. You may now send the newly completed Face-to-Face request to the doctor for signature via Fax or click on the PDF to view the filled-out request that you have saved, save it to your files and you can send it out to the doctor via email, through a physician portal, etc.
Face to Face Encounter Page
Once you Click Save, the system will automatically take you to the View Face to Face Encounter Page, located in the Clinical Menu>Face to Face Encounter>View Face to Face encounter.
Under Action, we have to option to View the PDF, Edit the Face-to-Face encounter request Document, Delete the Request or Fax it.
No real Client or Employee information was used.