For the Physicians and Nurse Practitioners: Benefits for Having the End of Life Conversation
What Services Are Provided by Soreo Hospice?
Soreo Hospice has a medical director, a team of nurses who are specially trained in palliative care and symptom control, home health aides, social workers, spiritual counselors, grief and bereavement specialists, and volunteers to provide a wide array of services which include but are not limited to:
- Weekly and PRN visits by the RN Case Manager to ensure management of the patient’s physical pain and symptoms
- Home Health Aid visits 2-3x per week to provide personal and ADL care
- Regular and PRN visits by the Social Worker and Chaplain to provide emotional, spiritual, and social support to the patient, caregivers, and loved ones
- Education, support and coaching loved ones on how to care for the patient
- Delivery of medications, medical supplies, and equipment routinely and as needed
- Assistance with applying for entitlements (ALTCS, VA benefits), understanding and completing Power of Attorney documents, arranging end of life plans, etc
- Assistance with obtaining in-home caregiving support, respite care, and out-of-home placement as needed
- Availability of short-term inpatient care when pain and symptoms become too difficult to manage at home or the caregiver needs respite
- Education about the dying process, what to expect, and how to cope
- Available 24 hours a day, 7 days a week, 365 days a year
- Grief support for caregivers and loved ones for 13 months following the patient’s death
Why should I refer patients to Soreo Hospice?
Because it’s the compassionate thing to do for terminally ill patients and their families. Soreo Hospice provides home based medical, psychosocial, spiritual, and social services that no doctor or clinic is able to provide on their own.
As a physician you will know that you made the right referral at the right time and to the right specialty. Most doctors say that the high quality of end-of-life care is the number one reason they make referrals to hospice. You can still follow your patient and be paid for that service.
Will Soreo Hospice respect my wishes as the patient’s physician?
Soreo Hospice is all about respecting wishes. We respect the wishes of the patient and we admire and respect our patients’ attending physicians.
Does hospice care mean that I’m giving up my patient?
No, if you want to continue as the attending physician, Soreo Hospice supports that doctor-patient relationship. If you choose to refer your patient to the Soreo Hospice physician, we will continue to keep you informed of your patient’s status.
How do I know if hospice care is appropriate for my patient?
Request a Soreo Hospice evaluation. Our specialists can help you determine the prognosis and care needs of your patient.
Do I get paid if I continue to see my patient?
Yes. Soreo Hospice can provide your office staff the information and codes so that you can bill and be paid for your professional services.
How do I bill for consulting physician services for Soreo Hospice patients?
At the time when a Medicare beneficiary elects hospice care, he/she may designate an attending physician. (The attending physician is defined by Medicare as the physician or nurse practitioner which is identified by the individual at the time he/she elects hospice coverage as having the most significant role in the determination and delivery of his/her medical care)
- If the attending physician is NOT employed by Soreo Hospice, the attending physician or nurse practitioner can bill directly to Medicare Part B for their services for reimbursement.
- When billing Medicare Part B as the “attending physician” (which may include a Nurse Practitioner), the HCPCS modifier GV must be submitted for the services provided to patients enrolled in Soreo Hospice. Services submitted without one of these modifier will be denied.
- The GV modifier indicates the attending physician is NOT employed or paid under an agreement by the patient’s hospice provider.
- Services by a nurse practitioner are only billable if the nurse practitioner has been elected, by the patient, as the attending physician.
Professional services related to the terminal illness provided by any physician other than the “attending physician” are considered to be “consulting physician” services. The consulting physician must look to Soreo Hospice for payment of these services. Soreo Hospice will bill Medicare Part A and reimburse the physician based upon a contractual agreement.
The consulting physician must have a signed letter of agreement with Soreo Hospice. One agreement for a group of physicians is permitted as long as all of the physicians in that group are listed on the agreement.
Soreo Hospice is responsible for reimbursing the physician for the services as indicated in the letter of agreement. Soreo Hospice currently reimburses 100% of the Medicare fee schedule. No co pays are collected from the patient.
The services must be related to the terminal illness and within the hospice plan of care. Initially, claims should be submitted to Soreo Hospice for review to determine payment.
If the service is determined by Soreo Hospice to be unrelated to the terminal illness the physician should bill Medicare directly using the GW modifier. The GW modifier indicates the service was not related to the patient’s terminal illness. Services submitted without this modifier will be denied.
If the service is determined by Soreo Hospice to be outside the plan of care, the physician should bill Medicare directly.
Physicians Assistants and Nurse Practitioners are not allowed to bill Soreo Hospice as a consulting physician as the hospice is unable to receive reimbursement from Medicare Part A. They should bill Medicare and other insurance companies directly.