{"ref":"LA-HSP-FIN-01","title":"Patients With No or Limited Payor Source, Charges and Billing Integrity","category":"Business","summary":"Sets out the Agency’s policy for patients with no or limited payor source (required by Louisiana), how patients are told about charges in advance, continuation of care regardless of ability to pay, the Medicare notices and caps, the Louisiana Medicaid hospice filing deadlines, and billing accuracy.","inShort":["A patient who is eligible for hospice is not turned away only because they have no or limited insurance. The Administrator decides each case.","Patients are told in writing about any charges they may have to pay before services begin.","Medicare and Louisiana Medicaid forms have short deadlines. Give signed election and certification forms to the office the same day.","Never ask a patient to sign a blank form, and never change a date or signature.","Bill only for care that was ordered, given and documented, at the level of care that was ordered."],"primaryCitation":"LAC 48:I §8235.D.1.e","citations":["LAC 48:I §8235.D.1.e","LAC 48:I §8217.A.2.e","LAC 48:I §8231.A.3, 10","LAC 48:I §8219.B.5","LAC 48:I §8207.A.11.e","Louisiana Medicaid Services Manual, Chapter 24 (Hospice), §§24.2, 24.6, 24.7"],"federalCitations":["42 CFR §418.100(d)","42 CFR §418.24(e)","42 CFR §418.26(e)","42 CFR §418.28(d)","42 CFR §418.301(c)","42 CFR §418.302","42 CFR §418.309","42 CFR §424.516(f)"],"surveyorAsks":["Show me your policy for patients with no or limited payor source. How many such patients have you served this year?","How are patients told about charges they may have to pay before services begin?"],"forms":[{"ref":"LA-HSP-FIN-01-A","title":"Payor Source and Financial Assistance Review"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (LAC 48:I §8235.D.1.e)","5. Payor Review at Referral","6. Patients With No or Limited Payor Source","7. Information About Charges","8. Medicare Notices and Caps","9. Louisiana Medicaid Hospice Requirements","10. Billing Accuracy","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":"la-hospice","state":"Louisiana","service":"Hospice","guides":[{"path":"/guides/hospice-policies/","h1":"What policies are required for hospice?"},{"path":"/guides/hospice-conditions-of-participation/","h1":"Hospice Conditions of Participation: which policies each one needs"}],"agency":{"name":"Sample Agency","legalName":"Sample Agency, LLC","logo":null}}