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Who are you caring for?
Which best describes their mobility?
How well are they maintaining their hygiene?
How are they managing their medications?
Does their living environment pose any safety concerns?
Fall risks, spoiled food, or other threats to wellbeing
Are they experiencing any memory loss?
Which best describes your loved one's social life?
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By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid. We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour. APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
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V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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Mostly Independent
Your loved one may not require home care or assisted living services at this time. However, continue to monitor their condition for changes and consider occasional in-home care services for help as needed.
Remember, this assessment is not a substitute for professional advice.
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That might include travel charges, but you won't know unless you ask. Do you feel like your dad is not getting adequate care from the visiting doctors?
So in the state of NJ and PA (I have worked in both states) the billing takes into account the time the dr or np reviews the chart, distance, how long the dr or np was at the house and if the dr or np prescribe a medication or labwork. We used Enoble Care for my dad. It was not the best or the worst. My dad went thru 5 drs/np in just 1 years. So, we felt like there was no continuity of care.
No. Medicare does not have a rule requiring a visiting doctor in New Jersey to bill a minimum of one hour for a home visit. Medicare home/residence visits use E/M codes, and they can be selected based on either medical decision-making (MDM) or, alternatively, total time on the date of the encounter.
For an established patient, the current home-visit codes correspond to these time levels when the provider chooses to bill based on time: 99347: 20 minutes 99348: 30 minutes 99349: 40 minutes 99350: 60 minutes
However, here’s the important wrinkle: 20 minutes physically inside Dad’s home doesn’t necessarily mean they can’t legitimately bill a higher-level visit. If they’re selecting the code based on medical decision-making rather than time, a shorter face-to-face visit can qualify for a higher code if the documented complexity supports it. CMS recognizes the 99341–99350 family for Medicare home/residence visits.
On the other hand, if they’re actually claiming 60 minutes of time as the basis for the billing, that’s something I’d question if the doctor is routinely there for only 20 minutes.
I’d look at Dad’s Medicare Summary Notice (MSN) or Medicare.gov account and find the CPT/HCPCS code being submitted. If it’s 99350, don’t immediately conclude they’re billing Medicare for an hour they didn’t spend there—the code can also represent a high-complexity established-patient home visit.
If you post the exact code appearing on one of Dad’s Medicare claims (probably 99347, 99348, 99349 or 99350), I can tell you exactly what Visiting Doctors is billing Medicare for and whether a 20-minute visit could legitimately support it.
It does not matter what State you live in, billing Medicare is the same all over the US.
I live in NJ, my PCP bills by minutes like Geaton posted. I would call and talk to the doctors billing office and ask your question. For house calls the doctor maybe able to bill for an hour. You are going to pay more for that service. In the longrun, though, Medicare is only going to pay what they think is reasonable and then pay 80% of that. Hopefully, the supplemental will pay the 20% Medicare does not pay.
Dr bills $200, Medicare will only cover $160, 80% 128, balance hopefully supplemental picks up $32.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
No. Medicare does not have a rule requiring a visiting doctor in New Jersey to bill a minimum of one hour for a home visit. Medicare home/residence visits use E/M codes, and they can be selected based on either medical decision-making (MDM) or, alternatively, total time on the date of the encounter.
For an established patient, the current home-visit codes correspond to these time levels when the provider chooses to bill based on time:
99347: 20 minutes
99348: 30 minutes
99349: 40 minutes
99350: 60 minutes
However, here’s the important wrinkle: 20 minutes physically inside Dad’s home doesn’t necessarily mean they can’t legitimately bill a higher-level visit. If they’re selecting the code based on medical decision-making rather than time, a shorter face-to-face visit can qualify for a higher code if the documented complexity supports it. CMS recognizes the 99341–99350 family for Medicare home/residence visits.
On the other hand, if they’re actually claiming 60 minutes of time as the basis for the billing, that’s something I’d question if the doctor is routinely there for only 20 minutes.
I’d look at Dad’s Medicare Summary Notice (MSN) or Medicare.gov account and find the CPT/HCPCS code being submitted. If it’s 99350, don’t immediately conclude they’re billing Medicare for an hour they didn’t spend there—the code can also represent a high-complexity established-patient home visit.
If you post the exact code appearing on one of Dad’s Medicare claims (probably 99347, 99348, 99349 or 99350), I can tell you exactly what Visiting Doctors is billing Medicare for and whether a 20-minute visit could legitimately support it.
I live in NJ, my PCP bills by minutes like Geaton posted. I would call and talk to the doctors billing office and ask your question. For house calls the doctor maybe able to bill for an hour. You are going to pay more for that service. In the longrun, though, Medicare is only going to pay what they think is reasonable and then pay 80% of that. Hopefully, the supplemental will pay the 20% Medicare does not pay.
Dr bills $200, Medicare will only cover $160, 80% 128, balance hopefully supplemental picks up $32.