{"ref":"MI-HH-ADM-01","title":"Referral Intake, Acceptance-to-Service, and Public Information About Services","category":"Service delivery","summary":"Sets out how the Agency receives and screens every referral, applies one written acceptance-to-service policy to every prospective patient (anticipated needs, caseload and case mix, staffing levels, and staff skills and competencies), records the decision, tells the referral source and the patient the outcome, refers onward when it cannot accept, and keeps accurate public information about its services and their limits. It applies the Michigan Medicaid rules on service setting, health plan authorization, evaluation visits and selective acceptance.","inShort":["Write down every referral at once, with the date and time, and pass it to intake.","Only the clinical manager decides whether we accept a referral, using the same written criteria every time.","Never promise a service before the referral is accepted.","If we cannot accept, tell the referral source and the person the same day and offer other agencies.","Public information about our services must be accurate and is reviewed at least once a year."],"primaryCitation":"42 CFR §484.105(i)","citations":["Michigan Medicaid Provider Manual, Home Health, Sections 1, 2, 13.3 and 13.4","Michigan Medicaid Provider Manual, General Information for Providers, Sections 8.1, 8.2 and 8.4"],"federalCitations":["42 CFR §484.60","42 CFR §484.105(c)(3)","42 CFR §484.105(i)","42 CFR §484.50(a)","45 CFR §92.101"],"surveyorAsks":["Show me your acceptance-to-service policy. When was it last reviewed, and by whom?","Walk me through what happened to the last three referrals you did not accept. How was each decision made and recorded?"],"forms":[{"ref":"MI-HH-ADM-01-A","title":"Referral Intake and Acceptance Decision Record"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (42 CFR §484.105(i))","5. Receiving a Referral","6. The Acceptance Decision","7. After the Decision","7.1 Referral Accepted","7.2 Referral Not Accepted","7.3 Persons Already Under Another Provider’s Care","8. Michigan Medicaid and Health Plan Referrals","9. Public Information About Services","10. Annual Review of This Policy","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":"mi-hha","state":"Michigan","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}}