Certification and Recertification of Terminal Illness and Face-to-Face Encounters
Sets out the Georgia requirements for a physician referral, a written certification of a life expectancy of six months or less, and the six-monthly face-to-face assessment or life-expectancy scale with written certification, and the Medicare requirements for certification and recertification in each benefit period: timing, the 2-day oral certification, the 15-day windows, the narrative and attestation, who signs, and face-to-face encounters before the third and each later benefit period, including the telehealth limits.
About this policy
- Policy number
- GA-HSP-ELC-02
- Version
- 1.0
- Main rule
- 42 CFR §418.22
- Library
- Georgia hospice · 60 policies
- Category
- Hospice care
- Sections
- 20
In short
- Every benefit period needs a written certification signed and dated by the hospice physician before billing.
- If the written certification is not ready within 2 calendar days after the period starts, get an oral certification and record it at once.
- The physician writes the narrative for this patient, right above the signature. No check boxes or standard wording.
- From the 3rd benefit period, a hospice physician or hospice nurse practitioner sees the patient within the 30 days before each recertification.
- Georgia also requires a face-to-face assessment or a life-expectancy scale, with written certification, at least every six months.
What's inside
20 sections. The full text comes with the One-time Policy Pack.
- Terms of Reference
- 1. Purpose
- 2. Scope
- 3. Definitions
- 4. Policy Statement (Ga. Comp. R. & Regs. 111-8-37-.14(2)(d); 42 CFR §418.22)
- 5. Timing of Certification (Medicare)
- 6. Who Certifies
- 7. Content of the Certification
- 8. Georgia Six-Month Certification
- 9. Face-to-Face Encounters (Medicare)
- 10. Oral Certifications and Filing
- 11. When the Physician Will Not Recertify
- 12. Georgia Medicaid
- 13. Responsibilities
- 14. Records and Compliance Monitoring
- 15. Staff Training
- 16. References
- 17. Related Policies and Forms
- 18. Approval
- 19. Revision History
An inspector may ask
- Show me the written certification for each benefit period for this patient, signed and dated, with the benefit period dates.
- Where is the physician’s narrative, and is it composed for this patient and placed immediately before the signature?
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