{"id":8156,"date":"2024-02-26T09:16:02","date_gmt":"2024-02-26T09:16:02","guid":{"rendered":"https:\/\/matrixbricks.us\/suncrest\/?p=8156"},"modified":"2024-09-21T07:39:17","modified_gmt":"2024-09-21T07:39:17","slug":"after-choosing-hospice-can-patients-see-their-regular-doctors","status":"publish","type":"post","link":"https:\/\/matrixbricks.us\/suncrest\/after-choosing-hospice-can-patients-see-their-regular-doctors\/","title":{"rendered":"After Choosing Hospice, Can Patients See their Regular Doctors?"},"content":{"rendered":"

Hospice care<\/span><\/a> is all about helping the terminally ill to be as comfortable as possible as the end of life draws near. One of the most comforting aspects of hospice is that services can be provided wherever a patient lives, be that a private Cleveland home, a residential care center or a local hospital. Care providers come to the patient \u2013 but can individuals on hospice care still go see their regular doctors?<\/span><\/p>\n

There is a great deal of confusion surrounding this issue, even among medical professionals, but the short answer is yes. That being said, the Medicare hospice benefit has limitations on outside medical care. Here\u2019s what patients in Cleveland, Ohio, need to know.<\/span><\/p>\n

\"hospiceMedicare Allows Hospice Patients to Appoint an Attending Physician<\/b><\/h2>\n

Upon choosing hospice care, patients can select an attending physician, or the doctor who will be responsible for overseeing their medical care. This individual works closely with the other members of the hospice team to meet the patient\u2019s physical, emotional, social and spiritual needs \u2013 and yes, the attending physician can be the patient\u2019s regular doctor.<\/span><\/p>\n

Medicare will permit a hospice patient to continue seeing their own doctor, but only if that individual is the appointed attending physician. Under the Medicare benefit, only one doctor not employed by hospice can receive payment for medical care related to the hospice diagnosis.<\/span><\/p>\n

What does that mean?<\/span><\/p>\n

Every hospice patient has a primary diagnosis, whether it\u2019s congestive heart failure, lung cancer, dementia or some other end-stage disease. When it comes to care related to that diagnosis, only the attending physician gets paid by Medicare. If a patient sees a different doctor for treatment connected to their terminal illness, Medicare will not pay.\u00a0\u00a0<\/span><\/p>\n

Can Hospice Patients See Other Doctors for Urgent Care?<\/b><\/h2>\n

As we\u2019ve explained above, only one physician not employed by hospice can bill Medicare for medical care that is related to a patient\u2019s primary diagnosis. But what about services that aren\u2019t part of the hospice diagnosis? Does Medicare pay other doctors when they provide urgent care to a Cleveland hospice patient?<\/span><\/p>\n

Yes, but in the event of a medical emergency \u2013 such as an accidental fall resulting in a broken arm or a cut that requires stitches — patients are expected to contact the hospice care team instead of calling for ambulance transportation or heading to a local hospital. The team then calls 911, explaining that the patient they are about to assist is in hospice care.<\/span><\/p>\n

Why is the Medicare-approved approach?<\/span><\/p>\n

The reason for having the hospice care team make the necessary arrangements is to keep emergency medical services (EMS) personnel from attempting to treat symptoms related to the primary diagnosis. If the hospital or urgent care staff isn\u2019t informed, they may provide care that isn\u2019t covered by Medicare. And in that case, billing claims for those services are likely to be denied.<\/span><\/p>\n

Why Does Medicare Have these Conditions for Hospice Patients?<\/b><\/h2>\n

Medicare pays a bundled rate for services related to the hospice diagnosis \u2013 all of the medications, medical equipment and medical supplies a patient requires are covered, as are care services meant to meet the individual\u2019s physical, mental, spiritual and social needs.<\/span><\/p>\n

Having Medicare pay all of the costs of hospice care is certainly advantageous for patients, as it saves them a great deal in co-pays and deductibles. At the same time, the bundled benefit is the reason Medicare isn\u2019t willing to pay other doctors for services associated with a patient\u2019s terminal illness.<\/span><\/p>\n

How is that the case?<\/span><\/p>\n

Simply put, when someone enters hospice care, the Medicare benefit covers the full cost of the services they require. As they\u2019re already paying the hospice a bundled fee, Medicare isn\u2019t going to pay other medical professionals for those same services \u2013 that would result in duplicate payments, something the Centers for Medicare & Medicaid Services (CMS) is always trying to avoid.<\/span><\/p>\n

Hospice Care and Doctor Visits \u2013 Everything You Need to Know<\/b><\/h2>\n

If you were recently diagnosed with a terminal illness, you need to know about hospice care to make informed decisions moving forward. We\u2019ve mentioned that Medicare covers everything from medications to medical services, and if you happen to have Medicaid or private insurance, you\u2019ll be relieved to know that hospice care is typically a covered benefit.\u00a0\u00a0<\/span><\/p>\n

However, we realize that the whole doctor visit situation is somewhat confusing. So, we\u2019d like to highlight the key points to remember:<\/span><\/p>\n