Home Health

2. – Source of reimbursement rates for both Home Health and Hospice.
5. Type – Category used to classify Home Health and Hospice claims.
9. – Ensures benefits and responsibilities align between payors.
13. – Facility type used to determine certain Hospice pricing.
14. Plan – Outlines covered services; the baby is not covered under the mother’s plan.
15. – Care category with specific pricing and authorization rules.
16. – Special process used for certain Hospice review requirements.
17. – Requires separate billing from the baby in neonatal care.
18. – Payor type requiring an EOB on Hospice claims.
20. – Document required for secondary commercial Home Health claims.
21. Supplies – Reimbursable when approved under authorization.
23. – Must be billed separately from mother in neonatal cases.
24. – System rules used for reviewing claim details.
26. – Identified based on financial guidance such as DOFR.
27. – Method used to calculate reimbursement amounts in Hospice claims.
28. – Category covering instructions related to claim payment.

1. – Standard claim check used in both programs.
3. – Form used to bill Home Health services.
4. – System with a high-dollar threshold requiring review.
6. – Tasks rendered and billed on claims.
7. – Does not require an EOB for Hospice claims.
8. – Code included on final Home Health claims.
9. – Used to determine claim payment amounts.
10. Responsibility – Determined using guidelines such as DOFR.
11. – High-dollar limit requiring additional review in claims.
12. – Required for certain services or when documentation is found outside the system.
14. – Coordination of benefits required for certain secondary claims.
15. Health – Care type billed using UB claim forms.
19. – Supporting documents for pricing or authorization.
22. Rate – Hospice rate determined by facility pricing rules.
25. – Services for mother and baby must be billed separately.