Get Attestation Of Home Health Certification / Face-to-face ...

This guide provides comprehensive instructions on completing the Attestation of Home Health Certification / Face-to-Face Encounter form online. By following these steps, you will be able to accurately fill out the required information to ensure proper documentation for home health services.

Follow the steps to complete the form accurately.

1. Click ‘Get Form’ button to retrieve the Attestation of Home Health Certification / Face-to-Face Encounter form and open it in your preferred document editor.
2. In the section designated for the facility, enter the patient's name in the format of Last Name, First Name, followed by their date of birth.
3. Next, proceed to the section that must be filled out by the physician or their designee. Enter the date of the face-to-face encounter, ensuring to specify the month, day, and year.
4. Indicate the medically necessary services for the patient by selecting the applicable option(s): Skilled Nurse, Physical Therapy, or Speech Therapy. Provide detailed information about the services and care or treatments required.
5. Clearly state the medical condition that was the primary reason for the home health care in the designated area. This should reflect the reason for the face-to-face encounter.
6. In the section for clinical findings, provide the necessary details that support the need for the selected services. Describe how the patient's condition meets CMS guidelines for being homebound.
7. The physician must sign the form in the designated area, along with providing the date of their signature and printing their name beneath their signature.
8. Once all information has been accurately filled in, you may save changes, download, print, or share the form as needed.

Fill out the Attestation of Home Health Certification / Face-to-Face Encounter form online today to ensure all necessary documentation is in order.