Send it.
Fax 214-339-2733 or call 214-339-9466, Monday–Friday, 8 a.m.–5 p.m.
For case managers, discharge planners, SNFs and physician offices
Make a referral.
- First-dose IV and inotropes
- Wound VAC and complex wounds
- In-home PT/INR checks
- Ostomy care and teaching
Fax the referral packet or call intake. We review the orders, plan and address, and give you a yes or no within 30 minutes, Monday–Friday, 8 a.m.–5 p.m.
Referral fax214-339-2733
Call intake214-339-9466
How it works
How does a referral to BREMA work?
You send the packet, intake checks fit, and you hear yes or no within 30 minutes.
We check fit.
Intake reviews the orders, the health plan and the home address.
You hear back.
Yes or no within 30 minutes.
Care starts.
We call the patient or family to schedule the first visit.
Referral packet
What should a home health referral packet include?
Send the referral form, signed orders and face-to-face documentation, the history and physical or discharge summary, the medication list, both sides of the insurance cards, and the patient's address and best phone number.
- BREMA referral form or your facility's referral
- Signed orders and face-to-face encounter documentation
- History and physical or discharge summary
- Current medication list
- Front and back of insurance card(s)
- Patient address and best phone for the patient or family
For IV, wound VAC, PT/INR and ostomy referrals, see the extra items listed for each service.
Complex and specialty care: what to send for each serviceComplex and specialty care
See the complex care we accept
First-dose IV and inotropes, injections, new diagnosis teaching, ostomy care, wound care and wound VAC, and PT/INR testing, with what to send for each.
Health plans
Which plans does BREMA accept?
BREMA accepts Medicare and 28 other plans, including Medicare Advantage, commercial, military and workers' comp plans. Intake confirms each patient's benefits before the first visit.
We do not accept Medicaid or Medicaid managed care.
Search the full plan listMedicare
- Medicare
Medicare Advantage
- Aetna Medicare Advantage
- Amerigroup Medicare Advantage
- Anthem Medicare Advantage
- BSW Medicare Advantage
- Molina Medicare Advantage
- Superior Medicare Advantage
- UHC Medicare Advantage
- Wellcare Medicare Advantage
- Wellpoint Medicare Advantage
Other plans and payers
- Ambetter
- Carelon
- Cigna Commercial
- Curative Health Plan
- HOMELINK
- Humana
- Imperial Health
- Medicare MVA/MVC
- MTI America
- Oscar
- ProCare Advantage
- Provider Network of America
- Tango Care
- Tricare
- TriWest
- UHC Commercial
- Verdegard
- WellMed
- Workers' Comp
For physician offices
What does Medicare require to certify home health?
The patient must be homebound and need intermittent skilled nursing, physical therapy or speech-language pathology, or have a continuing need for occupational therapy. A physician or allowed practitioner certifies the need and signs a plan of care, and a face-to-face encounter related to the main reason for home health must happen within 90 days before or 30 days after the start of care.
Face-to-face encounter
- Timing: no more than 90 days before, or within 30 days after, the start of care
- Related to the primary reason the patient needs home health
- Can be done by telehealth
- Performed by the certifying physician or allowed practitioner, a physician who cared for the patient in the acute or post-acute facility they came from, or a nurse practitioner, clinical nurse specialist, certified nurse-midwife or physician assistant as state law allows
- The certifying practitioner documents the encounter date
Homebound documentation
Both criteria must be met and supported in the record.
- Criterion one (one of these): needs a supportive device, special transportation or another person's help to leave home because of illness or injury, or leaving home is medically contraindicated.
- Criterion two (both): normally unable to leave home, and leaving requires a considerable and taxing effort.
- Describe the patient, not the rule. For example: walks 20 feet with a walker before resting, needs one-person assist on stairs.
The plan of care lists the services, the disciplines, and the frequency and duration of visits. Therapy needs measurable goals. The certifying practitioner reviews and signs the plan at least every 60 days.
This summary of CMS rules is for convenience. It is not legal or billing advice. See the CMS sources for the full requirements.
Sources: CMS Medicare Learning Network, Home health services compliance tips (opens in a new tab); 42 CFR 424.22 (opens in a new tab)
Your liaisons
Call us directly.
Quick fit check
Ask before you send the packet.
Tell us the plan, the area and the care needed. We'll call you back with a yes or no.
How do I refer a patient to BREMA?
Fax the referral packet to 214-339-2733 or call 214-339-9466, Monday through Friday, 8 a.m. to 5 p.m. BREMA gives a yes or no on referrals within 30 minutes.
Does BREMA accept high-acuity referrals?
Yes. BREMA accepts referrals for first-dose IV medication and inotropes, injections, new diagnosis teaching, ostomy care, wound care and wound VAC, and PT/INR testing, along with skilled nursing and physical, occupational and speech therapy.
How fast will I know if BREMA can take the patient?
You’ll have a yes or no within 30 minutes of sending the referral, Monday through Friday, 8 a.m. to 5 p.m.
Does BREMA provide home inotrope infusions?
Yes. BREMA provides inotrope infusions at home for patients with heart failure, with nursing visits, monitoring and family teaching as ordered by the physician.
Who decides on a dose change after a home INR check?
The prescriber does. BREMA sends the result to the prescriber, who decides whether the dose should change, and the nurse helps the patient follow the new instructions.
Can a patient get home health for PT/INR checks alone?
No. A blood draw alone doesn’t qualify a patient for Medicare home health. The patient also needs another qualifying skilled need, such as skilled nursing, physical therapy or speech therapy.
Does Medicare cover complex care at home?
Yes, if the patient qualifies for home health. Medicare covers the skilled nursing visits. IV drugs and wound VAC equipment may be billed separately, depending on the item and the plan.
Can a nurse practitioner or physician assistant certify home health?
Yes. Nurse practitioners, clinical nurse specialists and physician assistants can certify Medicare home health and sign the plan of care, as Texas law allows.
Can the home health face-to-face encounter be done by telehealth?
Yes. CMS allows the face-to-face encounter to be performed by telehealth, as long as it relates to the primary reason for home health and falls within the required timeframe.
Does BREMA accept Medicaid patients?
No. BREMA does not accept Medicaid or Medicaid managed care plans. If a patient has Wellpoint coverage, check that it is Wellpoint Medicare Advantage, which BREMA accepts.