Homecare

Signed Plan of Care Required for Homecare Prior Authorization

Homecare is experiencing an increasing number of prior authorization denials related to unsigned Plans of Care. Insurance plans will no longer accept an unsigned Plan of Care when reviewing requests for home health prior authorization.

Please be aware that the payers have a strict seven‑day submission window for providing a signed Plan of Care to request prior authorization. If the signed Plan of Care is not submitted within this seven‑day window, the prior authorization request is automatically denied and the case must then proceed through the appeals process.

To avoid delays in care, administrative burden and avoidable denials:

• A signed Plan of Care must be obtained and submitted promptly
• Unsigned Plans of Care will no longer be submitted for prior authorization
• Missing this seven‑day window will result in denial and appeal, not retroactive approval

This requirement is being consistently enforced across both Ohio Medicaid and commercial insurance plans. Your support in ensuring timely, complete Plan of Care signatures is critical to maintaining authorization approvals and uninterrupted patient care. Email the Homecare Finance team HomecareFinanceLeadership@NationwideChildrens.org with questions or concerns.

Homecare Providing Respiratory Services

Homecare is pleased to introduce Respiratory Services, now available throughout Franklin County. Designed to support patients with complex pulmonary needs in the home setting, Respiratory Services currently offers oxygen therapy and pulse oximetry, with plans to expand to more devices in the near future.

Ordering these devices follows the same process currently used to refer to outside agencies through Epic. A clinical respiratory therapy referral is available to allow a licensed respiratory therapist to see patients in their home on a routine or an as-needed basis, depending on clinical need. This referral can also be found in Epic and should be ordered with each patient equipment order.

Integrating respiratory care into homecare offerings provides more coordinated, patient-centered support, helping to improve outcomes while reducing the burden on patients, families and providers. The Homecare team is committed to being a trusted partner in extending high-quality respiratory care beyond the clinical setting. For questions about the O2 program, email respiratory manager, Renae.Forsythe@NationwideChildrens.org.