Determining Hospice 485 Certification Dates
Overview
Staff verifying Medicare enrollment should determine the patient’s current hospice benefit period before creating the hospice 485 certification period in Barnestorm.
Previous hospice election and certification periods can typically be reviewed through Medicare DDE or payer eligibility systems.
Hospice Benefit Periods - First and second hospice benefit period = 90 days each
- All remaining benefit periods = 60 days
Finding Existing Hospice Benefit Periods
Existing hospice benefit periods and prior certifications may be reviewed using:
- Medicare DDE
- Payer eligibility systems
- Transfer documentation from the prior hospice agency
- Existing Barnestorm patient records
The Medicare DDE system has a screen that records this information. Barnestorm takes the 485 from/thru dates as entered and assumes that the agency has done their homework to determine which benefit period is current. The hospice benefit period is recorded in Barnestorm under the Referrals > Payers > Hospice Tracking.
Report 19.08 pulls a detailed list of patients and benefit periods, or a summery that provides counts of the same.
Standard Hospice 485 Certification Dates
If the patient is starting a new hospice certification period, the 485 certification dates should match the applicable hospice benefit period dates.
The certification period should be determined based on:
- Previous hospice election periods
- Prior certification dates
- Current hospice benefit period
Hospice Transfers Between Agencies
When a patient transfers from another hospice agency during an active hospice certification period, the certification dates do not restart.
Important: A hospice certification period split across two providers must maintain the same certification end date.
If the transferring agency has an active hospice 485:
- Your certification start date is the patient’s admission date to your agency.
- Your certification end date remains the same as the transferring agency’s current certification thru date.
- Use the Special date option on the Create a New 485 screen to manually enter the certification dates.
If No Active Certification Exists
If the transferring agency does not have an active hospice 485 certification period, create the hospice 485 using the standard certification period dates based on the patient’s current hospice benefit period.
Determining Hospice 485 Certfication Dates