{"ref":"FL-HH-BUS-02","title":"Billing, Claims, Signed Treatment Orders Before Billing, and Overpayments","category":"Business","summary":"Requires every claim to be for services actually provided, ordered, documented, and covered, requires treatment orders to be signed before a claim for skilled services is submitted, keeps charges to patients to those disclosed in the service agreement, and sets the 60-day rule for reporting and returning overpayments.","inShort":["We bill only for visits that really happened and are documented and ordered.","Skilled visits are not billed until the treatment orders are signed.","Write your visit note at the time of the visit. Never chart ahead or record something you did not see.","Tell your supervisor the same day about any missed visit. Missed visits are not billed.","If we find we were paid too much, we pay it back."],"primaryCitation":"s. 400.487(2), F.S.","citations":["s. 400.487(1), F.S.","s. 400.487(2), F.S.","s. 400.474(2)(d), F.S.","s. 400.474(4), F.S.","s. 400.474(5), F.S.","s. 409.913(7), F.S.","s. 409.913(9), F.S.","s. 409.913(10), F.S.","s. 409.913(11), F.S."],"federalCitations":["42 U.S.C. §1320a-7k(d)","42 CFR §401.305","42 CFR §484.50(c)(7)","42 CFR §484.50(c)(8)"],"surveyorAsks":["Show me how you make sure the treatment orders are signed before you submit a claim for skilled services.","How do you check that every billed visit actually happened and is documented?"],"forms":[],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (s. 400.487(2), F.S.)","5. Conditions Before Any Claim Is Submitted","6. Prohibited Billing Practices","7. Charges to Patients","8. Billing Reviews","9. Overpayments","10. Medicaid Records","11. Responsibilities","12. Records and Compliance Monitoring","13. Staff Training","14. References","15. Related Policies and Forms","16. Approval","17. Revision History"],"version":"1.0","sample":false,"pack":"fl-hha","state":"Florida","service":"Home health","guides":[{"path":"/guides/home-health-agency-policies/","h1":"What policies and procedures are required for home health agencies?"},{"path":"/guides/home-health-conditions-of-participation/","h1":"Home health Conditions of Participation: which policies each one needs"}],"agency":{"name":"Sample Agency","legalName":"Sample Agency, LLC","logo":null}}