I work at a rehab hospital and our physicians certify Home Health services. In the past we always billed when we received a 485 form from the Home Health Agency. I’m finding that I don’t always get those forms. I depended on those to confirm that the patient started home health. From what I’ve been reading, no form is required to be filled out if all information is in a note.

My questions are:
Can we only bill these codes when the patient has started HH or can I bill without confirmation relying on the fact that a note certifying the need is present?
How are your physicians confirming that the service has started?
Are you finding that a chart note is sufficient or are you still using the 485?

Thanks.