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Hospice care treats the whole person, providing physical, emotional and spiritual support of seriously ill patients and their families. The focus of hospice care is not to cure the patient but, instead, to enhance the patient’s quality of life through symptom management.

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Healthcare Professionals

Is Hospice Care Covered by Insurance?

Many hospice services are reimbursed by Medicare, Medicaid, and private insurance coverage. However, thanks to the support of our donor community, no one is denied care because of an inability to pay.

Patients Covered by Medicare or Medicaid Hospice Benefit

All needs relative to the primary illness are covered with no deductible or co-payment. That includes medications, oxygen, hospital bed or any other needed home medical equipment and supplies. The attending physician continues to bill as usual.

Payment Guide for Hospice Patients

Situation #1

  • Physician has been designated by the patient as the attending physician.
  • Attending physician is not an employee of the hospice.
  • Services are related to the hospice patient’s terminal illness.

Use: “GV” modifier

  • Attending physician is not employed or paid under agreement by the hospice.

Situation #2

  • Physician is covering for a hospice patient′s designated attending physician.
  • Physician is not an employee of the hospice.
  • Services are related to the hospice patient′s terminal illness.

Use: “GV” modifier

  • Attending physician is not employed or paid under agreement by the hospice.

 Use: “Q5” modifier

  • Services being billed by the attending physician were provided by a covering physician.

Situation #3

  • Physician has been designated by the patient as the attending physician.
  • Attending physician is not an employee of the hospice.
  • Services are NOT related to the hospice patient′s terminal illness.

Use: “GW” modifier

Service is not related to the hospice patient′s terminal condition.

 


 

Understanding Reason Code C7010

Reason code C7010 is generated when records show that the beneficiary has elected the Medicare hospice benefit and services billed as being related to the terminal diagnosis by a non-hospice provider. This aid includes information on how to resubmit clams that receive Reason Code C7010.

 


 

We appreciate your interest in care from Hospice of the Piedmont and Hospice of Randolph. Please call us for more information anytime during normal business hours (Monday through Friday, 8 a.m. to 5 p.m.) in High Point at 336.889.8446 or in Asheboro at 336.672.9300. After hours or on weekends, please leave a message and we will get back to you within 30-minutes.

 


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