Hospice not certified and doesn't bill Medicare. Is this typical? Something's fishy....

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SoVeryExhausted Asked January 2021

Hospice not certified and doesn't bill Medicare. Is this typical? Something's fishy....

I have asked previously about the NH putting my mom on Hospice. Her mobile Dr said she didn't think she would qualify. The hospice that the nursing home referred contacted me and said it would not affect her United Health Care Medicare Advantage. Fast forward 2 months.
Because of an error with retiree account with UHC (long, long story) I thought the hospice had affected her Medicare. I text the NH and said I was going to call the hospice and if they caused a problem with my mother's Medicare I was going to fire them. I tried calling the hospice # and what sounded like an elderly woman answered *hello* I said sorry wrong #. Then my husband tried calling the # same thing. I got a call from the hospice and the *Director* started screaming at me. I couldn't get a word in. She said they don't bill Medicare they do everything for free. I said do you report anything to CMS? The screaming intensified and she said *we aren't certified* we have nothing to do with CMS or Medicare! I screamed over the top of her YOUR FIRED.
This all seems wrong. Am I wrong? Or is this sketchy?

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score 1 · Answer 1

Neither have I heard of a Hospice doing it free. There has to be a doctor affiliated with it to prescribe meds. You are uncomfortable about it, fire them and hire another Hospice. Mom is a resident so she has a right to chose the Hospice she wants. I would also report the other Hospice. Never heard of free Hospice. Volunteers to visit, yes. Medicare pays fully for the service.

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I think since Medicare pays for Hospice and people do not get a bill they think it is "Free"

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score 2 · Answer 2

Please report this hospice agency to the appropriate authorities ASAP, as something definitely is fishy. And the fact that the director had the nerve to scream at you is beyond comprehension. Hospice is supposed to be supportive, understanding and helpful, which is the exact opposite of what you have experienced. I am so sorry that you had to go through that, but good for you for firing them. I would have done the same thing. Hospice is covered 100% under Medicare(and yes that means everything is filed with them)including any necessary equipment, medications, supplies(like diapers, pads, catheters etc.)oxygen and more. Hopefully there is a another hospice agency in your area, that will treat your mom and you better. Good luck.

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score 1 · Answer 3

Thank you! My stress level is crazy. I am now in a full blown ulcerative colitis flare.
This is a residential home set up for 5 residents. A friend of mines mother was there for years it came highly recommended. I have had no problems with the NH itself. But I think there must be a connection between the NH and hospice. The hospice has a NPI registered as a hospice. Why would they provide free diapers?
I keep 2nd guessing myself. I thought I put enough time into researching hospice.
Thank you again for all the help this forum has provided.

Helpful Answer (1)

The Hospice I used for my Husband provided ALL the supplies as well as all the equipment that I / we needed. This was all billed to Medicare. I never got a bill. Hospice does provide these supplies.
In general there are 2 types of Hospice
FOR profit Hospice
NOT for profit.
The one I happened to select was a NOT for profit.
Please do not let this incident turn you away from Hospice. They can be of great help and it is never to early to contact them.

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score 2 · Answer 4

Sounds like someone in the Nursing Home is getting kickbacks for referral to a (I hate to say this) a bad Hospice organization.
I would withdraw from the Hospice. Contact another in your area they will take care of transferring her from the “illegitimate” one to a certified Hospice.
I think I would report both the Hospice and the Nursing Home to the State Ombudsman as well as file complaints with the Government Medicare site that rates facilities

Helpful Answer (2)

That's what I don't understand? They do things for free? There must be angle somewhere? I don't want to cause problems for my mother right now. I have her mobile Dr going tomorrow and I'll get a report how she's doing. I don't think she is ready for hospice. I dunno weird stuff.

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score 3 · Answer 5

Yes, something is very wrong. Regular Hospice is covered by Medicare. And almost always fully covered, no matter what they order including hospital bed. Something is very wrong. Who ordered this Hospice. Contact them for explanation. Something is very wrong here.

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score 2 · Answer 6

The NH recommended this organization?

Talk to the business office at the NH. Very sketchy.

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score 1 · Answer 7

Um, yeah.

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Hospice not certified and doesn't bill Medicare. Is this typical? Something's fishy....

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