Person was attending PT at an outpatient office. Then had Homehealth come for a different issue. HH agent states they explained to patient that you cant do both. The patient never told them about outpatieent visits and continued. Outpatient agent also told the patient at the start of care that they cant do both at same time. Medicare recouped payment from outpatient office.
Can the patient be billed for services since they were advised?
My assumption would be YES, the patient can be billed for the Home Health PT sessions and held responsible for payment of services rendered - because they consumed the services for both outpatient and in home PT and the resources for both must be paid by someone. The patient was advised not once but at least twice that they could not "double dip" but continued to utilize both services. Now Medicare has paid the outpatient service - but I'm assuming they will not pay the home health service because it was a double service. So, yes, the patient can (and should) be held responsible for paying that bill, especially given that they were aware that Medicare wouldn't cover both.
I wouldn't worry this until and unless a bill shows up.
IF your elder is without funds, then do know that unpaid medical bills just pile on up. Medicaid, SS, SSDI is not funds that can be attached in any court action.
Then there's always a -- you know -- poor memory. As in "No one told me any such thing! That's a lie". In this day and age, with what is happening in medical care, pharmaceuticals, costs, Hospice being ground down to nothing much at all, my moral code is slipping. At 81 I "play it as it lays" to quote the late great Joan Didion.
I would take a wait and see on this one. Get back to us when chapter II arrives.
IMO, if Medicare is not paying you for the overlapping visits, then you bill the client. There must be a statement from Medicare saying why you are not being paid. But, I wonder, since the PT is for two unrelated problems, why would not Medicare pay? Maybe, because to get in home care you are not suppose to be able to be an outpatient?
I would call Medicare and run by them the care was for two different things and see what they say. If they stand by their guns, then you need to bill the client. In the long run its the clients fault for not telling you they had homecare. They are responsible for the visits with you. Hard lesson to learn. But homecare is done because the person cannot leave their home for outpatient care.
What a grind! PT and OT in HH Is enough.
Later on, do the other if needed.