{"ref":"MO-HSP-FIN-01","title":"Billing Integrity, Payment Liability Notices and MO HealthNet Requirements","category":"Business","summary":"Sets out how the Agency tells patients in writing what they may have to pay and about any change within 30 days, records the determination of financial responsibility, continues care regardless of ability to pay, files Medicare notices on time, meets the MO HealthNet hospice program rules (participation, levels of care, room and board, inpatient limit, documentation and six-year retention), and keeps billing accurate.","inShort":["At admission, give the patient the written Notice of Payment Liability and explain what they may have to pay.","If what the patient owes changes, the patient must be told in writing within 30 days of the Agency learning about it.","No patient's care is cut or stopped because they cannot pay.","Bring signed election, revocation and discharge papers to the office the same day so Medicare notices are filed on time.","Bill only for care that was given, written down and signed, at the level of care actually provided."],"primaryCitation":"19 CSR 30-35.010(1)(F)3.I","citations":["19 CSR 30-35.010(1)(F)3.C, I","19 CSR 30-35.010(2)(K)5.G","RSMo §197.264.1","13 CSR 70-50.010","13 CSR 70-3.030(2)(C)","13 CSR 70-3.030(3)(A)16","13 CSR 70-3.320(2)(C)","RSMo §191.905"],"federalCitations":["42 CFR §418.24(e)","42 CFR §418.26(e)","42 CFR §418.28(d)","42 CFR §418.100(d)","42 CFR §418.302","42 CFR §418.309","42 CFR §418.400","42 U.S.C. §1320a-7k(d)"],"surveyorAsks":["Show me how this patient was told in writing what they might have to pay.","When the patient's liability changed, when did you become aware of it and when did you tell the patient?"],"forms":[{"ref":"MO-HSP-FIN-01-A","title":"Notice of Payment Liability"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (19 CSR 30-35.010(1)(F)3.C and I)","5. Telling Patients What They May Pay","6. Care Regardless of Ability to Pay","7. Medicare Billing (If Medicare-Certified)","8. MO HealthNet Hospice Program","9. Private Insurance and Private Pay","10. Billing Accuracy and Audits","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":"mo-hospice","state":"Missouri","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}}