Revocation Form For Hospice
Description
How to fill out Letter Revoking An Offer?
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FAQ
A hospice revocation is a beneficiary's choice to no longer receive Medicare covered hospice benefits. To revoke the election of hospice care, the beneficiary/representative must give a signed written statement of revocation to the hospice.
If the hospice determines that the patient is no longer terminally ill with a prognosis of six months or less, they must discharge the patient from their care. Other reasons why a hospice may discharge a patient include: Death of the patient. The patient revokes the hospice benefit.
Revocation of Hospice Benefit Hospice cannot ?revoke? a patient. A revocation is initiated by the patient or their responsible party. Upon discharge or revocation of hospice care, the beneficiary immediately resumes the Medicare coverage that had previously been waived by the hospice election.
To revoke the election of hospice care, the individual must file a document with the hospice that includes a signed statement that the individual revokes the election for Medicare coverage of hospice care for the remainder of that election period and the effective date of that revocation.
At the time your claim was processed, your patient was enrolled in Hospice care on this service date. Hospice dates can change if a patient revokes Hospice care. A revocation indicator of ?1? (or any number other than ?0?) indicates the hospice benefit has been revoked.
