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home-care reimbursement

What happnes when a patient begins a home-care therapy, and has to stop it due to hospitalization. Is the homecare agency losing profit for the period of time this patient is hospitalized or does it get paid upfront for the entire period? who bears the hospitalization costs?

Home IV therapy & hospitalization

In our infusion pharmacy we usually deliver meds weekly.  If a patient is hospitalized during that time we still submit and are usually paid for meds that were made "in good faith".   On discharge from the hospital S.O.P. in my experience is that a new order is needed for therapy to continue at home.  Jan Weller, R.N.

Home Infusion Reimbursement

Jan is correct in that in most cases only a week of drug and supplies are sent out at a time.  This is usually due to drug stability, weekly lab results and sterility factors.  You bill for what you send out-so billing would be done on a weekly basis for these patients.  If a patient is admitted to the hospital infusion companies may or may not get paid depending on the type of insurance that they have.  You may be able to get that "good faith" clause with some, but with the majority they consider it "double billing" and will not reimburse home infusion-if they do pay and then find out the patient was in-house then they typically will demand a refund from the infusion comany.  Depending on how long the patient is in-house the drug at home may still be usuable if they discharge home on the same med.  Once they are admitted we have to have a new script even if the med stays the same.  Hope this helps.

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