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Hi Barbara,

I would like it if you post something on HouseCalls. I have learned as I go along, and my housecalls are still in the infancy stage. However, I find that I really enjoy them. The patients are a lot more comfortable, and they are very appreciative. Key points- If patients have insurance, make sure that you check ahead of time when you negotiate your credentialing contracts with the insurance companies that they will cover housecalls, and under what conditions, ie lack of mobility, age or no transportation. The insurance company may be wary, as the reimbursement rate is slightly higher. However, Medicare will pay for housecalls, but it must be stated in the notes why a home visit was necessary. It is also important to be clear with the insurance companies that you are a provider and this is not to be confused with Home Health.

In addition, make sure you have your medical bag stocked. If possible having a duplicate to what is in the office helps, so that you do not have to trek things back and forth, or forget something at someone’s home. Key items to have in your “housecall bag” include: thermometer, rapid strep kit, bp cuff, (right size), stethoscope, portable otoscope and opthalmoscope, reference books, including those for prescriptions, prescription pad, soap note paper, hand sanitizer, and pulse oximeter. In addition, alcohol wipes, guaze, and other dressing supplies are helpful. I use a lot of hand sanitizer, and if I want to check a pulse ox, I always clean the patient’s finger off with alcohol or hand sanitizer prior to using my pulse ox. I clean off my stethoscope and other instruments with this or alcohol as well. If the patient is new to you, and you have never seen them in the office, you need to bring the registration, health history and hippa forms for signature. At some point you will need to get a copy of the insurance card. If the patient does not have a copier, they usually do not mind if you take their card, and bring it back after you make a copy. Some providers do not take 3rd party reimbursement. If this is the case, make sure you have brochures that state your fees, and when scheduling a home visit, tell the patient on the phone prior to the appointment what the cost will be, usually based on time spent, so there is no sticker shock after driving out the the home and completing your exam. The more clear the communication, the better the health care experience. I am finding that established not new patients make the best housecall patients. They already trust you, and are more likely to want you in the privacy of their home, and you do not need to worry about copying insurance cards, or bringing new patient paperwork for signatures. All in all it is very rewarding, and although I only have about 4 “regular” housecall patients right now, they get quickly attached to this type of visit as well, and soon you will find that they prefer being at home in their pajamas and quite willing to let you trek around town to their house for their visit. Carla Anderson, FNP