Wiki Hospice Billing

Conni

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Can anyone tell me if there is a difference when it comes to billing commercial insurances for hospice charges? I'm not that familiar when it comes to coding and billing for Hospice.
I work for a small commercial insurance carrier and have a provider that is billing for Routine Home Hospice Care and told me that they bill all insurance types the same following Medicare guidelines which is to bill on a per diem basis.
The problem is that a member has indicated that Hospice is only coming once a week, however the provider is billing everyday for Hospice services on the UB-04 claim submission.
I found what the provider told me to be very interesting and I have spent a a good amount of time trying to find information that supports what the provider told me. I have found information that indicates Medicare is paid on a per diem basis, but yet to find something that indicates all insurance types are billed the same for Hospice like Medicare on a per diem.
It just seems awful strange that a patient would be billed for more days of Hospice care then what they are actually being seen for.
If anyone can give me more insight on the billing of Hospice services to commercial insurance would greatly be appreciated.
 
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