VNS Health Total: Home Health Agency Care

Intermittent skilled nursing, therapy, social work, and home health aide services provided in the home to support recovery or address functional decline.

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Cost
$0
Prior Authorization Required
Yes
Provider Referral or Order Required
Yes

How To Receive

Details on how to apply

  1. Obtain an in-network provider order for home health services.

  2. Contact VNS Health Total Care Team at (866) 783-1444 (TTY 711) for prior authorization.

    • The provider ordering home health will most likely assist with prior authorization.

  3. Select a network home health agency: Click on the Ancillary Services tab on the page, then click on Certified Home Health Agencies (CHHA).

    • Note that VNS Health also has a home health agency.

  4. Contact the home health agency to schedule an admission/intake visit (also called the “start of care” visit).

    • Typically the selected agency is sent the order for home health directly, and will therefore make first contact.

Availability
Ongoing, until goals are met or until progress toward goals ceases
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Home health is a wide range of health care services that can be provided in the home for an injury or illness.  Often it is implemented following a hospitalization or skilled nursing facility stay. To qualify for home health care, the recipient must be deemed homebound* (leaving home takes considerable and taxing effort, or illness could get worse by leaving home) and a provider must certify that home health services are needed.

Home health services include, but are not limited to, part-time or intermittent skilled nursing and home health aide services; physical, occupational, and speech therapy; medical and social services; and medical equipment and supplies.  Skilled nursing and home health aide services combined must total fewer than 8 hours per day and 35 hours per week to be covered under the home health care benefit.

*Note that since the COVID-19 pandemic, the Centers for Medicare and Medicaid Services have relaxed homebound requirements; check with a provider for qualifying criteria.

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