{"ref":"GA-HH-BUS-02","title":"Charges, Billing, Claims, and Overpayments","category":"Business","summary":"Makes sure the Agency bills only for services that were ordered, provided, documented, and signed as the rules require; tells patients about charges before care begins; and finds, reports, and returns overpayments on time.","inShort":["We only bill for visits that were ordered, actually made, and written up in a signed, dated note.","Write your note the same day as the visit, and never change a note to match a bill.","The plan of treatment and oral orders must be signed by the physician before Medicare is billed.","Patients are told what they may owe before care starts.","If you think we were paid for something we should not have been, tell the Administrator right away."],"primaryCitation":"42 CFR §409.43","citations":["Ga. Comp. R. & Regs. 111-8-31-.06(u)","Ga. Comp. R. & Regs. 111-8-31-.07(6)","Ga. Comp. R. & Regs. 111-8-31-.09(b)","Ga. Comp. R. & Regs. 111-8-31-.09(c)","Ga. Comp. R. & Regs. 111-8-31-.09(d)"],"federalCitations":["42 CFR §409.43","42 CFR §424.22","42 CFR §401.305","42 CFR §1001.1901","42 CFR §484.50(c)(7)","42 CFR §484.50(c)(8)","42 U.S.C. §1320a-7k(d)","31 U.S.C. §3729"],"surveyorAsks":["Show me how you make sure the plan of treatment and any oral orders are signed before a claim is sent.","How do you tell patients what Medicare, Medicaid, or their insurer will pay and what they will owe?"],"forms":[],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (42 CFR §409.43 and Ga. Comp. R. & Regs. 111-8-31-.09(b)-(c))","5. Telling Patients About Charges","6. Conditions Before a Claim Is Sent","7. Claim Review","8. Overpayments","9. Responsibilities","10. Records and Compliance Monitoring","11. Staff Training","12. References","13. Related Policies and Forms","14. Approval","15. Revision History"],"version":"1.0","sample":false,"pack":"ga-hha","state":"Georgia","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}}