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Who makes the homebound determination?

April 26, 2017determination homebound

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Who makes the homebound determination?

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A9. Determinations concerning medical necessity or homebound status are the responsibility of the medical professionals treating the patient. The home health agency can assist the medical professional in making eligibility determinations and in understanding the standards governing home health coverage criteria in order to ensure that the claims meet all legal requirements. The home health agency is accountable for the appropriate and timely submission of claims. Inappropriate claims could result in de-certification of the home health agency.