Organizations that have palliative care or pre-hospice programs can utilize Hummingbird for tracking patient data, clinical documentation and billing to Medicare Part B and other insurances.
Access to Palliative Care (PC) Program
Palliative Care is a separate program which must be set up by mumms Home Office. Please contact mumms Software Office at 504-525-0620 to request.
- As patients are referred, palliative patients will be assigned to PC Program
- Various reports (census reports, statistical reports, AR reports, etc) can be run for PC Program only, Hospice only, or Both programs.
HBCSpecific forms can be created for use with palliative patients or hospice can utilize the hospice forms for PC patients. Editing charges may apply when creating PC-specific forms.
ADMIN Set Up
PC Program information
If the Palliative Program has a name that is different from the hospice’s name, it can be entered in ADMIN/Site along with NPI, Fed Tax ID, etc.
Roles
- Specific “palliative care” roles for forms mapping purposes can be set up in ADMIN/Roles
- “Palliative Care SW” role may be necessary, as there may be some SWs who are qualified to make billable visits, and others may not be.
Persons & Physicians
assign the appropriate PC role to the PC staff that will be visiting PC patients.
Visit Types
You may wish to establish visit types specifically for palliative care, especially if you are creating specific PC forms. List the visit types you desire and have your HBC Liaison add to the forms editing.
Insurance
In ADMIN/Insurance Carriers all options in the “details” float are related to hospice claims (such as UB Bill type). Any PC patient with billable visits will bill on a 1500 claim form by default. Simply ensure that your PC carriers are entered in to PIM.
CPT/HCPCS codes
CPT/HCPCS codes are set up in ADMIN/Physician Services. Choose all CPT/HCPCS codes to be used in PC billing, including Social Work visit codes and add to “favorites”. Modify the billing rate under “Rate” fields (Facility and non Facility) if desired.
Discharge Codes
You may wish to create discharge codes specifically for your PC program, such as “Transfer to Hospice”, “DC-No longer wants PC services”, etc. This is done in ADMIN/Discharge Codes. These codes would mostly be used in reports and would NOT be appropriate for use for hospice patient discharge.
Data Entry
- Patient demographic data is entered into PIM exactly the same as for hospice patients, except you will choose Palliative in the “Program” field when entering a PC referral.
- Palliative care procedures (billable visits) are entered 2 ways:
- Manually key into the “Interactions” Widget. Drag from the widgets drawer on the right side of the Home Page. Enter date, time, duration, patient, worker. Float will open to allow entry of the CPT/HCPCS code and diagnosis codes. Close and enter mileage (if desired) and +.
- Physicians using HB-Clinical will record their visit information along with the CPT/HCPCS code, and related diagnosis on a form. When the visit is closed, the visit data, including CPT/HCPCS code and diagnosis will transfer over to PIM for inclusion in the claim.
Billing
PreBill Process:
As patients are admitted to the PC Program and physician visits are entered, claims are created automatically and are seen on the Claims Management Widget (CMW)/Not Sent tab.
- Visit Report will display all visits including CPT/HCPCS codes and rates.
- Exceptions will show on the Exceptions tab after running (see Billing Instructions) or choose “Download” to download a batch of claims to review.
- Click gear of any claim to see details.
- Claims will show as READY once all necessary information is entered. If missing information, claims will display ERROR. Click to determine the missing information.
Prepare Claims
- Go to CMW/Not Sent
- Filter by “Program” to be able to view a listing of all READY PC claims.
- Choose “Submit”. Enter date range, PC Program, and specific patient name (just begin typing) or leave blank to include all READY claims.
- Claims are sent to payer via Zirmed.
Reports
All of the reports under the “Reports” menu are able to be run for “Hospice Program” or “Palliative Program ” or “ALL”. Choose the desired program and date range.
Use of HBC for PC
- Use of HBC for PC is the same as for hospice patients. Work with Liaison to create/edit specific forms and Care Plans for PC use as desired. (The default data set already contains PC forms; use a “Demo” visit type to access.)
- Workers who work only with PC patients can be set up in PIM/ADMIN/Persons or Physician with specific PC roles; this will direct the worker to specific PC Visit Types and to the specific PC forms. Workers who work with both hospice and PC will be able to access both; no need to use specific PC roles.