To all of our referring physicians, thank you so very much for continuing your support of Promise Hospice. The numbers of patients we serve on a daily basis continues to grow and we greatly appreciate how much this demonstrates the confidence you have in us to care for your patients and their loved ones.

For those physicians who may not have made a decision to refer a terminally-ill patient to Promise, we would encourage you to consider doing so. We would be honored to serve you and your patient.

Why should I refer patients to Promise Hospice?

Because it’s the right thing to do for terminal patients. Promise Hospice can provide symptom control, patient and family support that no doctor or clinic could provide on their own.

What’s in it for me?

As a physician you will know that you made the right referral at the right time and to the right specialty. Most doctors say that the high quality of end-of-life care is the number one reason they make referrals to hospice. You can still follow your patient and be paid for that service.

What does Promise Hospice do that I can’t?

Promise Hospice provides specialty nurses and doctors, trained in palliative care and symptom control. Home health aides, chaplains, social workers, grief and bereavement specialists, and volunteers are on the team that supports you in the care of your patient.

Will Promise Hospice respect my wishes as the patient’s physician?

Promise Hospice is all about respecting wishes. We respect the wishes of the patient and we admire and respect our patients’ attending physicians.

Does hospice care mean that I’m giving up my patient?

No, if you want to continue as the attending physician, Promise Hospice supports that doctor-patient relationship. If you choose to refer your patient to the Promise Hospice physician, we will continue to keep you informed of your patient’s status.

How do I know if hospice care is appropriate for my patient?

Request a Promise Hospice evaluation. Our specialists can help you determine the prognosis and care needs of your patient.

Do I get paid if I continue to see my patient?

Yes. Promise Hospice can provide your office staff the information and codes so that you can bill and be paid for your professional services.

How do I bill for consulting physician services for Promise Hospice patients?

At the time when a Medicare beneficiary elects hospice care, he/she may designate an attending physician. (The attending physician is defined by Medicare as the physician or nurse practitioner which is identified by the individual at the time he/she elects hospice coverage as having the most significant role in the determination and delivery of his/her medical care)

• If the attending physician is NOT employed by Promise Hospice, the attending physician or nurse practitioner can bill directly to Medicare Part B for their services for reimbursement.
• When billing Medicare Part B as the “attending physician” (which may include a Nurse Practitioner), the HCPCS modifier GV must be submitted for the services provided to patients enrolled in Promise Hospice. Services submitted without one of these modifier will be denied.
• The GV modifier indicates the attending physician is NOT employed or paid under an agreement by the patient’s hospice provider.
• Services by a nurse practitioner are only billable if the nurse practitioner has been elected, by the patient, as the attending physician.

Professional services related to the terminal illness provided by any physician other than the “attending physician” are considered to be “consulting physician” services. The consulting physician must look to Promise Hospice for payment of these services. Promise Hospice will bill Medicare Part A and reimburse the physician based upon a contractual agreement.

• The consulting physician must have a signed letter of agreement with Promise Hospice. One agreement for a group of physicians is permitted as long as all of the physicians in that group are listed on the agreement.
• Promise Hospice is responsible for reimbursing the physician for the services as indicated in the letter of agreement. Promise Hospice currently reimburses 100% of the Medicare fee schedule. No co pays are collected from the patient.
• The services must be related to the terminal illness and within the hospice plan of care. Initially, claims should be submitted to Promise Hospice for review to determine payment.
• If the service is determined by Promise Hospice to be unrelated to the terminal illness the physician should bill Medicare directly using the GW modifier. The GW modifier indicates the service was not related to the patient’s terminal illness. Services submitted without this modifier will be denied.
• If the service is determined by Promise Hospice to be outside the plan of care, the physician should bill Medicare directly.
• Physicians Assistants and Nurse Practitioners are not allowed to bill Promise Hospice as a consulting physician as the hospice is unable to receive reimbursement from Medicare Part A. They should bill Medicare and other insurance companies directly.