Making a Referral
The first step
The initial call to CareFirst for any of our service options can come from any source — a member of the healthcare team, the patient, the family, a friend. If the call comes from someone other than the healthcare team or the patient, we must ensure that the patient is aware and approves that the referral is being made.
You may call us at any point, even if the referral or admission may not be immediate. For the most part, involving hospice before curative treatment ends or before caregiving arrangements are complete makes the transition time much easier. The patient and family appreciate and benefit from having time to learn what support systems will be in place after the changes occur. We can also often assist in making these arrangements. Call the CareFirst Admissions Team at 607.962.3100.
A preliminary question to ask yourself when deciding if a patient may be eligible for hospice is this: “If the disease runs its normal course, would I be surprised if this patient died of this diagnosis within the next year?” If the answer to this is “No”, and curative treatment such as chemotherapy and radiation are finished, the patient may very well be eligible for hospice care.
Medicare and Medicaid have developed guidelines for many diagnoses that are used by physicians to substantiate hospice eligibility. Completion of these diagnostic eligibility guidelines is a part of the admission process and will either be done by the patient’s physician or the CareFirst Admission Team. Review of these guidelines provides providers a good sense of which patients could benefit from Hospice services.
With the right documentation in place, admissions can happen the same day that we receive the referral. Admissions can occur 7 days a week. The following items will be requested from a primary physician or his or her team for a Hospice admission:
- Commitment from a physician or nurse practitioner to follow the patient on Hospice, including writing orders and supervising care (this commitment can either be in writing or verbal)
- History and physical from the past 6 months that substantiates patient’s condition
- Diagnostic eligibility guidelines as described above (this may be completed by the CareFirst Team)
- Demographics of the patient, including insurance information and social security number, if available
If available, the following items facilitate Hospice admission:
- Documentation of biopsy results, x-rays, scans, lab work and other clinical substantiation of the patient’s condition
- Hospital in-patient stay documentation, such as admission notes, ED visit notes or discharge summaries
- Advanced directives if in place
NOT required for admission:
Advanced directives are NOT required
Insurance is NOT required (a sliding fee scale is available for uninsured)
Patients CAN live alone (the CareFirst Team will work with patients to determine safe caregiving plans)
The CareFirst Admission Team and Medical Director stand ready to work with you to ensure that your patients get the best care possible. Call them at 607.962.3100 or fax at 607.937.8188.