{"ref":"MO-HC-BUS-01","title":"Service Authorization, Units of Service, and Billing","category":"Business","summary":"The Agency bills only what DSDS authorized and its workers actually delivered: 15-minute units including EVV entry time but not travel or breaks, partial units only within the month, MO HealthNet eligibility checked for the day of service, claims based on EVV-verified delivery and never on the authorization, a monthly reconciliation before billing, no charge to MO HealthNet participants for covered services, and prompt repayment of overpayments.","inShort":["The Agency bills only the time you actually spend giving authorized care in the participant's home.","One unit is 15 minutes. Time for your EVV entry counts. Travel, lunch and breaks do not.","Never record time you did not work or tasks you did not do.","MO HealthNet participants are never asked to pay for covered services.","If you think a visit was recorded wrongly, tell your supervisor the same day."],"primaryCitation":"19 CSR 15-7.021(17)","citations":["19 CSR 15-7.021(1)","19 CSR 15-7.021(15)(B)","19 CSR 15-7.021(17)(A)-(D)","19 CSR 15-7.021(18)(K)-(M)","19 CSR 15-7.021(24)(A)3","13 CSR 70-91.010(4)(A)-(B)","13 CSR 70-91.010(6)(E)","13 CSR 70-3.030(2)(A), (C)","13 CSR 70-3.030(3)(A)3, 4, 11, 12, 16, 23, 24, 26, 28, 30","13 CSR 70-3.030(6)(A), (B)","MMAC In-Home Services Program Requirements 3.1-3.4, 4.2.1","MO HealthNet Personal Care Provider Manual §§2.1, 2.5"],"federalCitations":[],"surveyorAsks":["Show me how you reconcile delivered units with the authorization before you bill.","How do you verify MO HealthNet eligibility for the day the service was delivered?"],"forms":[{"ref":"MO-HC-BUS-01-A","title":"Monthly Units Reconciliation"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (19 CSR 15-7.021(17))","5. What May Be Billed","6. Documentation Supporting Each Claim","7. Monthly Billing Procedure","8. Billing Practices That Are Never Allowed","9. Errors, Overpayments and Repayment","10. Responsibilities","11. Records and Compliance Monitoring","12. Staff Training","13. References","14. Related Policies and Forms","15. Approval","16. Revision History"],"version":"1.0","sample":false,"pack":"mo-hca","state":"Missouri","service":"Home care","guides":[{"path":"/guides/home-care-agency-policies/","h1":"What policies does a home care agency need?"}],"agency":{"name":"Sample Agency","legalName":"Sample Agency, LLC","logo":null}}