Reimbursement of Services
As a licensed and certified provider of hospice services, Good Samaritan Hospice is able to bill Medicare, Medicaid, Champus, Tricare, The Veterans' Administration and insurance carriers such as Preferred Provider Organizations (PPOs), Health Maintenance Organizations (HMOs), and traditional fee-for-service companies. For patients without insurance, Good Samaritan Hospice will provide services regardless of ability to pay.
The Medicare Hospice Benefit
Medicare covers services provided by qualified hospices, which have been certified by Medicare. Under this benefit, Medicare will cover basic costs, including the following services when authorized by Good Samaritan Hospice:
- Nursing services
- Personal care by a home health aide
- Medical equipment and supplies
- Medications related to the terminal illness
- Psychosocial, spiritual, and bereavement counseling services (for both patient and family)
- Inpatient care for pain control, symptom management, or short-term respite in a facility under contract with Good Sam
- Allied health professionals such as physical therapists, occupational therapists, speech therapists, and dietitians
- Lab and diagnostic tests related to the terminal illness
- Ambulance service for the purpose of change of level of care, such as transportation to the hospital for inpatient care or to a nursing home for respite
To receive hospice care under the Medicare Hospice Benefit, an individual must be entitled to Medicare Part A and be certified by the attending physician and the hospice medical director as having a life-limiting illness. The Medicare Hospice Benefit continues indefinitely, as long as there is physician certification of terminal illness. Patients can withdraw from the Hospice Benefit at any time and resume all regular Medicare benefits.