Fill in Your Nevada Fa 27 Form

Here are some important points to remember when filling out and using the Nevada FA 27 form:

• Purpose: This form is used by hospice agencies to notify HP Enterprise Services about enrollment, changes, or recertification of hospice recipients.
• Timeliness: Fax the completed form to HP Enterprise Services within 72 hours of any new or changed information.
• Required Attachments: Include a certificate of terminal illness, an election of hospice services, and updated physician orders for recertification.
• If the recipient is in a Nursing Facility, attach a PASRR screening and LOC Determination Letter.
• Fax Number: Send the form to (866) 480-9903.
• Contact for Questions: For any inquiries, call (800) 525-2395.
• Submission Date: Clearly indicate the date when the form is submitted.
• Accurate Information: Fill in all required fields, including hospice agency and recipient information, to avoid delays.
• Nursing Facility Information: If applicable, provide details about the Nursing Facility where the recipient resides.
• Ensure that the submitter's information, including signature and date, is included at the bottom of the form.

The Nevada Fa 27 form is essential for hospice agencies to notify HP Enterprise Services about a recipient's enrollment or changes in their hospice care. Several other forms and documents are often used in conjunction with this form to ensure compliance and proper care management. Below is a list of these related documents.

• Certificate of Terminal Illness: This document confirms the patient's terminal condition and is required for hospice enrollment.
• Election of Hospice Services: This form allows the patient or their representative to formally choose hospice care, outlining the services to be provided.
• Updated Physician Orders: Necessary for recertification, this document includes the latest medical directives from the attending physician regarding the patient's care.
• PASRR Screening: Required for patients in nursing facilities, this assessment determines if the individual requires specialized services due to mental illness or intellectual disability.
• LOC Determination Letter: This letter assesses the level of care needed for the recipient, particularly if they reside in a nursing facility.
• Arizona Bill of Sale Form: For those engaging in property transactions, consider utilizing the thorough Arizona bill of sale form guidelines to ensure all legal requirements are met.
• Form FA-24A: This form is used for care coordination when personal care services or waiver services are provided alongside hospice care.
• Medicare ID Document: If applicable, this document provides the recipient’s Medicare identification details, which may be necessary for billing and insurance purposes.
• Discharge Summary: This summary outlines the patient’s condition and care plan upon discharge from hospice services, ensuring continuity of care.
• Transfer Documentation: When a patient moves to a new facility, this document records the transfer details and ensures that all necessary information is communicated to the new care team.

These forms and documents work together to facilitate the proper management of hospice care and ensure that all legal and medical requirements are met. It is crucial to have them completed accurately and submitted on time to avoid any disruptions in care.