Home Health Care Questions & Answers

To qualify for home health services, you must have a medical need for the skilled services of a nurse or therapist. You must also meet Medicare’s definition of homebound, which means that leaving the home requires taxing effort and therefore you leave infrequently.

You can be temporarily homebound due to illness or injury. North Texas Home Care must also receive orders from your doctor to provide home health services. Upon request from you or referral from your doctor, we will coordinate with your doctor directly. We can provide home health services in assisted living facilities, residential care facilities and private residences.

Home healthcare is a Medicare Part A benefit, which requires no co-pay or deductible. Other payment sources may include Medicaid and private insurance. Some insurance policies will not cover all home health services unless certain conditions are met. If your insurance company does not cover the services you need, or you are uninsured, you may still obtain home healthcare through private pay or alternative funding sources.

Medicare will pay 100% for home health visits when they are the primary insurer, provided the following criteria are met:

• The patient is home bound
• The services required are for intermittent skilled professional care and are performed according to physicians orders
• The Home Health Care agency utilized is certified by Medicare
• The services are “reasonable and necessary”
• And Physician Face to Face Encounters have been met

North Texas Home Care services include:

• Skilled Nursing Care
• Physical Therapy
• Occupational Therapy
• Speech Therapy
• Home Health Aides
• Medical Social Services
• Medicare Guidelines
• Wound Care
• Post-Surgical Care
• Urological Care
• Cardiopulmonary Care/Teaching
• Pain Management
• Blood Glucose Monitoring
• Diabetic Management/Teaching
• Medication Teaching
• Medical Supplies
• Patient and Family Education on Disease Management
• Laboratory Services
• Blood Pressure Monitoring
• Home Exercise Program
• Gait/Transfer Training
• Protime (Onsite PT/INR Testing)

1. A referral comes to us from your medical provider.
2. Our Patient Care Coordinator calls you to set up your initial evaluation.
3. Depending on the doctor order and our evaluation, we order all necessary care.
4. We provide care for 60 days. At the end of this time period (or, certification), we continue serving you or you are discharged.

• Home Health is paid 100% by Medicare. That means you’ll pay $0 for your with Medicare.
• Private insurance pays for Home Health care; benefits vary and prior verification is recommended.
• Covered services are paid 100% by Medicaid; pre-authorization is required.