From Non-Medical Home Care Recipients:
Q. I receive non-medical home care or am responsible for someone who does and I would like Financial Health Services, LLC (“FHS”) to help me simplify paying for that care. I believe that the needed care would be covered by long-term home care insurance or by another third party payor. How do I get started?
A. First, please initiate a claim with the applicable insurance carrier or third party payor. Next, complete an FHS New Client Information form, which can be obtained from an FHS Pre-Certification Specialist or on the “Resources” page of the FHS website located at www.fhsbillings.com. Then, fax or email your completed FHS New Client Information form to an FHS Pre-Certification Specialist. The FHS fax number is 215-836-9756. Upon our receipt of your completed FHS New Client Information form, we will contact you to provide you with any additional forms you will need to complete, including an Assignment of Benefits form and an Authorization to Release Policy Information form. Please complete all required forms and return them to an FHS Pre-Certification Specialist.
Q. How do I know whether my policy will cover the care I need from the home care provider I have chosen?
A. Once we receive your completed Authorization to Release Policy Information form, we will call your insurance carrier or other third party payor to verify your benefits and coverage amounts.
Q. How long does it take to verify my insurance coverage or other third party payor coverage before I can begin to receive care?
A. Once we receive your completed Authorization to Release Policy Information form, your benefits can usually be verified within the following 24 - 72 hours. Please note that this estimate is an average and that the actual verification time frame varies by insurance carrier and third party payor.
Q. When my home care insurance or reimbursement benefits are assigned to FHS, how do the funds flow and payments get made?
A. To help simplify the payment process for the care you need, FHS receives and reviews the time slips submitted by your caregiver documenting the care provided to you, submits your claim for such care to your insurance carrier or applicable third party payor and pays your caregiver and/or their home care company on your behalf. In order to permit funds to be issued to FHS from your insurance carrier or applicable third party payor, the care recipient must complete an Assignment of Benefits form. FHS will fax this form to your insurance carrier or applicable third party payor when FHS receives the first time slip from your caregiver documenting the care that was provided. FHS will also attach this form to the invoice submitted to your insurance carrier or applicable third party payor for payment.
Q. What happens if my caregiver or their home care company wants to change their rates?
A. When your caregiver wishes to make a rate change, their home care company will forward an updated Schedule A to your insurance carrier or applicable third party payor. This updated Schedule A will be sent 30 days prior to the effective date of the proposed rate change and the change will go into effect automatically.
Q. What if the home care I receive or that is received by the person I am responsible for is not covered by long-term home care insurance or by another third party payor? Can FHS still help?
A. Yes. If you or someone you are responsible for pay privately for the non-medical home care needed, FHS can still help you simplify the process of paying for that care. You can contact FHS to set up an FHS EasyPay account. By setting up an FHS EasyPay account with FHS, you will pay FHS monthly for the care you receive and FHS will take care of the rest. FHS will, on a weekly basis, receive and process your caregiver time slips and issue payments to your caregiver and/or their home care company. For more information about setting up an FHS EasyPay account, please contact Tanya Turner, our Director of Billing, at firstname.lastname@example.org.
Q. How long does it take for a caregiver to receive payment for services rendered?
A. FHS will issue payment to caregivers within 24 hours of our receipt of the caregiver’s properly submitted time slips and applicable supporting documentation.
Q. Can caregivers receive their payments via direct deposit?
A. Absolutely! Paying caregivers via direct deposit benefits all involved and is FHS’ preferred method of caregiver payment.
Q. How long does it take for a third-party payor to pay FHS?
A. Payment time frames vary by insurance carrier and other third party payor. FHS receives payment from 14 days to 3 months after it submits a claim.
Q. How long does it take for the home care company that arranges for the care provided to receive payment from FHS?
A. FHS deposits all payments received from insurance carriers and other third party payors within 24-48 hours of its receipt of such payments. FHS will then issue payments to home care companies relating to such deposited amounts within 24-48 hours after the applicable deposit was made.
Q. What documentation is needed before an insurance carrier or other third party payor will pay an individual claim?
A. Claim requirements differ for each insurance carrier and third party payor. Most insurance carriers require an invoice and completed caregiver notes. Certain insurance carriers also require time slips and/or the submission of charges on using an applicable HCFA form or other claims form. To assist you with these widely varying requirements, we recommend that you contact us directly to discuss the specific requirements of your insurance carrier or other third party payor.
Q. What forms do most insurance carriers and other third party payors require to verify benefits and where do I find them?
A. In order to verify benefits, an Authorization to Release Policy Information form is required. Certain insurance carriers and other third party payors require use of their own custom Authorization to Release Information form. If the insurance carrier or other third party payor does not have its own custom form, an FHS Pre-Certification Specialist will forward FHS’ standard Authorization to Release Policy Information and other applicable forms to you for completion. Many of these forms are also available on the FHS website located at www.fhsbillings.com under “Resources”.
Q. Can care start before benefits are verified?
A. FHS will not issue payments to the caregivers until benefit verification has been completed.
Q. What is an elimination period?
A. Some long-term home care insurance policies have an elimination period ranging from 7 days to 3 months. During this elimination period, the home care recipient is liable for all or a portion of the cost of home care they receive.