Page 79 - Business Development Orientation Binder

VNSNY PROVIDER SERVICES

POLICY

POLICY TITLE: FIRST VISIT
Number: CP.103
Applies To: Certified Home Health Agency
Policy Section: Home Health Aides
Page 1 of 4

PURPOSE:
To define agency policy for the first visit made by disciplines.

To comply with Medicare Conditions of Participations (§484.55(a)) and State of
New York, Department of Health (Section 763.5) requirements for initial home
visit.

POLICY:

Acceptance of a Referral

1. All referrals are initially in Pending Referrals status until approved and
accepted by Clinical Field Manager (CFM).
2. Acceptance of the referral must occur timely to meet state and federal
requirements for initial assessment visit.
3. Acceptance of a referral does not necessarily mean that a patient will be
taken under care and home health services provided.
4. Acceptance of a patient for home health services is contingent upon the
professional nurse or professional rehabilitation therapist’s assessment
during the initial home visit to determine that the patient meets eligibility
criteria, accepts services, and can be safely and effectively managed in
the home setting. See CP.130 Admission to Home Care Policy.
5. In general, a payer source should be identified and verified for a case prior to
acceptance of a referral. In those cases in which prior authorization of home
health services by a third-party payer is required, agency acceptance of a
referral shall be contingent upon the entry of authorization.
6. After a new referral is entered, the payer will be verified by RCD (Revenue
Cycle Department) and any initial pending or non-pending authorizations will be
entered before the referral is reviewed and approved.

Initial Home Visit
1. After the pending referral is approved, the initial evaluation visit is
scheduled.
2. The initial visit identifies patient’s immediate care and support needs until
the plan of care be implemented. For Medicare beneficiaries, the initial

Policy Owner: VNSNY Provider Services
Reviewed: VNSNY Provider Services Quality & Patient Safety
Approved: SVP, Intake and Patient Care Services
Revised: 9/30/14, 12/31/15 04/18/2016, 10/11/2016, 03/17/2017, 12/2018