{"ref":"MO-HH-PR-03","title":"Patient Agreement, Informed Consent, and Disclosure of Charges","category":"Client rights","summary":"Sets out how the Agency obtains the patient's informed consent to care and keeps it current, signs a written services agreement, tells the patient orally and in writing before care starts what Medicare, MO HealthNet or another program is expected to pay and what the patient may have to pay, gives changes as soon as possible and before the next visit, gives written notice before possibly non-covered care, never bills a MO HealthNet participant for covered services, and tells MO HealthNet participants that electronic visit verification is a condition of services.","inShort":["Get the services agreement and consent signed before the first hands-on care.","Explain out loud and in writing what Medicare, MO HealthNet or insurance should pay and what the patient may owe.","If payment changes, tell the patient as soon as possible and before the next visit.","Never bill a MO HealthNet participant for covered services.","A patient may refuse any care. Respect it, explain the risks, document it and tell the clinical manager the same day."],"primaryCitation":"42 CFR §484.50(c)(4) and (c)(7) (adopted by 19 CSR 30-26.010(1)(A))","citations":["19 CSR 30-26.010(1)(A)","13 CSR 70-3.030(3)(A)3 and 4","13 CSR 70-3.320(2)(A), (D)","13 CSR 70-90.020","RSMo §197.445.2"],"federalCitations":["42 CFR §484.50(c)(4)","42 CFR §484.50(c)(7)","42 CFR §484.50(c)(8)","42 CFR §411.408(d)(2), (f)","42 CFR §§405.1200 to 405.1204"],"surveyorAsks":["Show me the patient's signed consent and services agreement. Were they signed before care started?","How did you tell this patient, orally and in writing, what Medicare or MO HealthNet would pay and what he or she might owe?"],"forms":[{"ref":"MO-HH-PR-03-A","title":"Home Health Services Agreement and Consent to Care"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (42 CFR §484.50(c)(4), (c)(7), (c)(8); 19 CSR 30-26.010(1)(A))","5. Before the First Visit: Verifying Payment","6. The Services Agreement","6.1 Who Signs","7. Obtaining Informed Consent","8. Refusal and Withdrawal of Consent","9. Telling the Patient About Payment and Charges","10. Changes in Payment or Charges","11. Written Notice Before Possibly Non-Covered Care or Reduced Care","12. MO HealthNet Participants: Electronic Visit Verification","13. Changes to the Agreement","14. Responsibilities","15. Records and Compliance Monitoring","16. Staff Training","17. References","18. Related Policies and Forms","19. Approval","20. Revision History"],"version":"1.0","sample":false,"pack":"mo-hha","state":"Missouri","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}}