Hospice Care
Clinical evidence,certifications, and care levels,in agreement.
Hospice documentation needs to support the terminal prognosis and the care provided. Circle connects hospice coverage requirements with visit findings and the broader record, helping teams prepare for certification, recertification, and billing review. Clinical decisions and physician attestations stay with clinicians.
100%
Chart review coverage
The record needs to support each benefit period and level of care. Bring the certification narrative, visit findings, and plan of care together for review.
Reimbursement structure
Medicare hospice uses two 90-day benefit periods followed by an unlimited number of 60-day periods, with recertification required. Payment reflects one of four levels of care. The record needs to support the terminal prognosis and the level of care billed. Original Medicare covers the Medicare hospice benefit for Medicare Advantage members. Medicaid and commercial requirements should be evaluated under the applicable program or policy.
Relevant requirements and guidance
- Medicare certification and payment requirements
- Applicable hospice LCDs
- Medicare Hospice Conditions of Participation
- State Medicaid requirements
- HOPE quality reporting
- Applicable accreditation standards
- State licensing requirements
How it works in your daily routine.
Care levels and documentation
The clinical record behind the level of care
Routine home care, continuous home care, respite, and general inpatient care serve different needs. Documentation should explain the care delivered and the clinical or caregiver circumstances supporting that level.
Illustrative GIP documentation review
- Review needed
Pain or symptoms requiring management
For clinician review
- Review needed
Why another setting cannot meet the need
For clinician review
- Review needed
Interventions and response documented
For clinician review
- Review needed
Ongoing need for GIP described
For clinician review
Built into every review.
Certification narrative
Patient-specific findings organized to support the physician's certification of terminal illness, with documentation questions surfaced for review.
Recertification evidence
Relevant visit findings and face-to-face documentation brought together to support the physician's review of continued eligibility.
Level-of-care documentation
The record reviewed for the care delivered and the circumstances supporting routine home care, continuous home care, respite, or general inpatient care.
Election and certification records
Relevant dates, signatures, and documents reviewed for completeness. Missing or unclear information surfaced for follow-up.
One plan across the team
Clinical observations and interventions reviewed alongside the plan of care so differences can be clarified in context.
Clinicians decide eligibility
Circle organizes evidence and identifies documentation questions. Eligibility decisions, certifications, and physician attestations stay with qualified clinicians.
What customers have measured.
100%
Chart review coverage
70%
Less time to a compliant note, expanding clinical capacity
As reported by Circle customers
2M+
Records processed
Know what each payer expects. Act before revenue is at risk.
See how Circle brings hospice coverage requirements and the clinical record together, from visit documentation to billing review.
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