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Cedar Grove Skilled Nursing
· (617) 555-0142Hospice Referral — Face Sheet + H&P
84yo F, end-stage CHF (NYHA IV) with recurrent admissions; SNF requesting hospice eval for comfort-focused care.
St. Bridget Regional Medical Center
· Case ManagementDischarge Referral — Hospice
71yo M, metastatic pancreatic cancer; discharge team referring to home hospice, target discharge Friday.
Mercy General · Dr. Alan Reyes
· In-BasketHospice Certification Order
Signed physician order certifying terminal prognosis under 6 months for 88yo M with advanced dementia.
ADA Referral Network
· Auto-routedNew Hospice Referral
77yo F, ALS with respiratory decline; ADA intake forwarded demographics and payer for hospice enrollment.
Aiden Intake Assistant
· Phone referralTranscribed Phone Referral
Daughter called re: 90yo mother, end-stage COPD on home oxygen; Aiden captured demographics and callback number.
HCC · Maria Delgado
· Field submissionIn-Person Referral Intake
HCC visited SNF; 82yo M with metastatic prostate cancer, family agreeable to hospice; intake form submitted.
Wellesley Hills Memorial Hospital
· Dr. Gregory LinPalliative Care Consultation
79yo M with stage IV gastric adenocarcinoma; palliative consult for symptom management and hospice transition.
Charles River General Hospital
· Uploaded by J. OkaforFace Sheet + Insurance Card
Coordinator uploaded scanned face sheet and Medicare card for 76yo F, stage IV colorectal cancer.
Peninsula Coastal Medical Center
Discharge Referral — Hospice
72yo F, stage IV endometrial cancer transitioning to comfort care; home hospice requested at discharge.
Mount Tamalpais Regional · Dr. Priya Nair
· In-BasketPalliative Care Consultation
77yo M, stage IV hepatocellular carcinoma; consult recommends transition to home hospice.
Availity — Payer Response
Eligibility Verification
Medicare Part A active for 84yo F; hospice benefit period 1 available — matches the Cedar Grove referral.