Hospice will need the following information to establish eligibility for services and finalize the referral:
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Insurance Information
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Social Security Number
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History & Physical
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Medication List
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Last two office notes
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Laboratory Values
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Pathology Reports
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Diagnostics (if available)
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Any imaging related to diagnosis
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PFT if diagnosis is end stage pulmonary
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Echocardiogram if diagnosis is end stage cardiac
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Consulting/Specialist Reports
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Advance Directive (if available)