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Physicians Home Health Care (PHHC) accepts reimbursement from Medicare, Medicaid, Commercial Insurance, Workers Compensation, Auto Insurance and Private
Pay provided there is a physician’s order and the individual meets the homebound criteria.
Home health services can be administered once the payer source has been verified.
Medicare Eligibility:
Before services can be provided by a home health agency the following conditions MUST always be met:
- The patient is an eligible Medicare beneficiary.
- The home health agency has a valid agreement to participate in the Medicare program.
- The services billed are covered Medicare home health services.
- Medicare is the appropriate payer.
- The services billed are not excluded from payment.
In addition, the following criteria must be met in order for home health services to be covered under the Medicare home health benefit:
- The services must be ordered by a physician.
- The services must be reasonable and medically necessary to the treatment of the patient’s illness or injury.
- The patient must be homebound.
- The patient must need a skilled primary service.
- Skilled services must be provided on an intermittent or part-time basis.
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