Agencies
Services
Provider Notice issued 07/16/08
Update to the Handbook for Home Health Agencies
Provider BulletinR-200-08-01
To: |
Participating Home Health Agencies |
| Date: | July 16, 2008 |
| Re: |
Update to the Handbook for Home Health Agencies |
Effective September 1, 2008, the department will standardize the prior approval and billing requirements for in-home shift nursing provided to children up to the age of 21. These requirements have been added to the Handbook for Home Health Agencies.
HFS staff will data enter prior approval requests that have already been approved under NPCS (Nursing and Personal Care Services) for dates of service on or after September 1, 2008 for non-DCFS children. A corrected HFS 2352 will be sent with an end date of 08/31/08 and a computer generated HFS 3076, prior approval notification, will be generated for dates of service 09/01/08 and after.
In-home shift nursing approved by the Department will be authorized on a weekly basis. Prior approval will be issued for a maximum number of hours per week, rather than a maximum number of hours per day. For example, rather than 8 hours per day, the approval will be for 56 hours per week. The weekly authorization will allow more flexibility in scheduling coverage. Adding the agency’s workweek to the HFS 1409 (prior approval request) is the only change being made to the prior approval paperwork and submission process.
Providers will be required to bill services on a weekly basis instead of daily. Providers will bill in-home shift nursing services on the paper HFS 2212 or electronically on the 837I which is available through Direct Data Entry (DDE) on the MEDI website <http://www.myhfs.illinois.gov/>. Services will be billed on a weekly basis in order to coincide with the prior approval, which will be issued at the department’s rate of RN services. The provider is obligated to bill for the actual service rendered (i.e.: LPN services).
In addition, this handbook update also refers providers to the department’s pharmacy guidelines for administration of Synagis injections.
The Handbook for Home Health Agencies, Chapter R-200 has been revised to reflect these changes and is available on the department’s Web site at: <http://www.illinois.gov/hfs/MedicalProviders/Handbooks/Pages/default.aspx>.
If you do not have access to the Internet, or need a paper copy, printed copies are available upon written request. You need to specify a physical street address to ensure delivery. Submit your written request or fax to:
Healthcare and Family Services
Provider Participation Unit
Post Office Box 19114
Springfield, Illinois 62794-9114
Fax Number: 217-557-8800
E-mail:hfs.webmaster@illinois.gov
Questions regarding this notice should be directed to the Bureau of Comprehensive Health Services at 1-877-782-5565.
INSTRUCTIONS FOR UPDATING HANDBOOK
Topic R-205 – Record Requirements
Remove page September 2007 HFS R-205 (2) and insert new page August 2008 HFS R-205 (2)
Topic R-211.2 - Approvals for Long Term Need
Remove page September 2007 HFS R-211 (4) and insert new page August 2008 HFS R-211 (4)
Appendix 1 - Technical Guidelines for Paper Claim Preparation Form HFS 2212, Home Health Invoice
Remove pages September 2007 HFS Appendix R-1 (1-10) and insert new page August 2008 HFS Appendix R-1 (1-10)
Appendix 2 - Preparation And Mailing Instructions for Form HFS 1409, Prior Approval Request
Remove pages September 2007 HFS Appendix R-2 (1-4) and insert new page August 2008 HFS Appendix R-2 (1-4)