Handouts For elearning Course: Medicare Conditions of Participation, ABN, HHCCN
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1 Handouts For elearning Course: Conditions of Participation, ABN, HHCCN For more information contact: Joan (646) or [email protected] HHC Health & Home Care 160 Water Street, 9th Floor, NYC (646)
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3 4 Documentation and Sample Home Health Agency AdvanceForms Beneficiary Notice (ABN) Home Agency StartHealth Of Care and Advance Beneficiary Notice (ABN) Start Of Care andchange Of Care Notice (HHCCN) Home Health Home Health Change Of Care Notice (HHCCN) Examples: ABN, HHCCN, and Notice of r Noncoverage Patient Has Patient Has?? NO MEDICARE ONLY MEDICARE NO ONLY 1 All All Paid For By Paid For By No ABN No ABN No ABN No ABN MEDICARE AND ANOTHER PAYOR AND MEDICARE ANOTHER PAYOR Not Eligible For Not Eligible For Coverage Coverage ABN ABN 2 No 3 Split Billing All Some service PaidNo Split By, Paid by Billing Paid For All By Paid Some service All Paid By, By, Paid by Another Paid For By Some by PayorAll Paid By, Another Another Payor Some by Payor Another Payor No ABN No ABN ABN ABN ABN ABN Updated January 2015 Updated January 2015 HHC Health & Home Care Nurse Orientation Manual 101
4 4 Home Health Agency Advance Beneficiary Notice (ABN) Home Health Agency Advance Beneficiary Notice (ABN) Discharge Documentation and Sample Forms Discharge and and Home OfCare CareNotice Notice (HHCCN) HomeHealth Health Change Change Of (HHCCN) andand Expedited Notice Expedited Determination Determination Notice Notice of Non-Coverage Notice of Non-Coverage Termination DecreaseInIn Termination Or Or Decrease Examples: ABN, HHCCN, and Notice of r Noncoverage Patient Has Patient Has?? NO MEDICARE ONLY NO MEDICARE AND ANOTHER PAYOR MEDICARE AND MEDICARE ONLY ANOTHER PAYOR 4A 4A Terminate ALL Terminate ALL 5 5 Decrease in Ordered Decrease in Ordered 6, 7 6, 7 Switch Billing Terminating Switch Billing Terminating ONLY But Non- ONLY Continue But Non- Continue No HHCCN No HHCCN No Need for HHCCN Use instead: No Need for Notice HHCCNof Use instead: NonNotice of Coverage NonCoverage HHCCN HHCCN Both HHCCN and Notice of Both HHCCN Non-Coverage and Notice of are Given Non-Coverage are Given 4B 4B Discharging ALL Discharging ALL Terminated Terminated No Need for HHCCN Use instead: No Need for Notice of HHCCN Use instead: NonNotice Coverage of NonCoverage Updated January 2015 Updated January HHC Health & Home Care Nurse Orientation Manual
5 Examples: ABN and Notice of r Noncoverage (Cont d) Sample 1 HHC Health & Home Care Nurse Orientation Manual 103
6 Example: ABN and Notice of r Noncoverage (Cont d) Sample HHC Health & Home Care Nurse Orientation Manual
7 Example: ABN and Notice of r Noncoverage (Cont d) Sample 3 HHC Health & Home Care Nurse Orientation Manual 105
8 Example: ABN and Notice of r Noncoverage (Cont d) Sample + 4A 4B 106 HHC Health & Home Care Nurse Orientation Manual
9 Example: ABN and Notice of r Noncoverage (Cont d) HHC Health & Home Care Nurse Orientation Manual 107
10 Example: Home Health Change of Care Notice (HHCCN) Sample HHC Health & Home Care Nurse Orientation Manual
11 Example: Home Health Change of Care Notice (HHCCN) Sample 6 HHC Health & Home Care Nurse Orientation Manual 109
12 Example: Notice of r Noncoverage (Cont d) Sample HHC Health & Home Care Nurse Orientation Manual
13 Example: Notice of r Noncoverage (Cont d) HHC Health & Home Care Nurse Orientation Manual 111
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