- #TIMELY FILING FOR MEDICARE HOME HEALTH CEERTIFICATION MANUALS#
- #TIMELY FILING FOR MEDICARE HOME HEALTH CEERTIFICATION MANUAL#
- #TIMELY FILING FOR MEDICARE HOME HEALTH CEERTIFICATION LICENSE#
Instructions for completing the PAR form are included in this manual. The form is available on the Provider Forms web page.
Adult members - the Department's designated formĪll pediatric LTHH PARs must be submitted via the utilization management vendor.Īll adult LTHH PARs must be submitted on the Department's designated Long-Term Home Health PAR form. Please submit the appropriate completed PAR via: For additional information on Health First Colorado plan of care requirements refer to the Home Health Services Benefit Coverage Standard referenced in 10 C.C.R 2505-10 § 8.522 - Covered Services. The plan of care must be signed by the member's attending physician prior to submitting the final claim for a certification period. The plan of care must be created by a registered nurse employed with the Home Health Agency or when appropriate by a physical, occupational or speech therapist. Any other documentation deemed necessary by the Department or its authorizing agency. All other supporting documentation to support your request including physician's orders, treatment plans, nursing summaries, nurse aide assignment sheets, medications listing, etc. The duties/treatments/tasks to be performed by each discipline during each visit. The specific frequency and expected duration of the visits for each discipline ordered. Member's diagnoses that will be addressed by Home Health, using V-codes whenever appropriate. The complete and current plan of care using the HCFA-485 or other document that is identical in content which must include a clear listing of:. A PAR is not considered complete until the authorizing agency reviews all information necessary to review the request. Long-Term Home Health PARs that are submitted more than ten (10) business days from the start date of the LTHH PAR shall have the PAR start date amended to the date of submission to the Department's authorizing agency. The Home Health PAR form must be completed and reviewed by the Department's authorizing agency before services can be billed. #TIMELY FILING FOR MEDICARE HOME HEALTH CEERTIFICATION MANUALS#
Authorizing agency information is listed in Appendix C and Appendix D, under the Appendices drop-down section on the Billing Manuals web page. However, if the member is enrolled in a Health First Colorado Managed Care Organization (MCO), such as Denver Health, Rocky Mountain Health Plans or Colorado Access Health Plan, please contact the MCO directly to determine the health plan's acute Home Health prior authorization requirements.Īll LTHH Services shall be submitted to the Department's authorizing agency as soon as possible, but no more than 10 business days from the start date of the LTHH PAR.
#TIMELY FILING FOR MEDICARE HOME HEALTH CEERTIFICATION MANUAL#
Refer to the General Provider Information manual for general billing information.Īcute Home Health Services do not need to be prior authorized. 2505 -10 § 8.520-8.529.Īll Home Health services provided are subject to post-payment review for medical necessity and regulation compliance. Home Health Agencies must comply with rules and regulations for Medicaid Home Health, including but not limited to the Home Health Benefit Coverage Standard and 10 C.C.R. Providers will find enrollment information on the Provider Revalidation & Enrollment web page.
Be in good standing with the Colorado Department of Health Care Policy & Financing, Colorado Department of Public Health and Environment (CDPHE), and MedicareĪfter obtaining licensure and certification as a Class A Home Care Agencies, an applicant must submit a completed provider enrollment packet to become a Health First Colorado eligible provider. Obtain Medicare certification and/or deemed status an accepted Home Health Accreditation entity: Joint Commission (JC), Community Health Accreditation Program (CHAP) or the Accreditation Commission for Health Care, Inc. #TIMELY FILING FOR MEDICARE HOME HEALTH CEERTIFICATION LICENSE#
Hold a current and active Class A Home Care License issued by the State of Colorado. 
In order to become a Health First Colorado Home Health Provider, an agency must: Submit claims for payment to the Health First Colorado.Providers must be enrolled as a Health First Colorado (Colorado's Medicaid Program) provider in order to: Please visit the Rates and Fee Schedule web page for daily and annual limits. Therefore, the information in this manual is subject to change, and the manual is updated as new billing information is implemented.
The Department of Health Care Policy & Financing (the Department) periodically modifies billing information.
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