{"ref":"TX-HSP-FIN-01","title":"Financial Solvency, Billing and Continuation of Care","category":"Business","summary":"Requires the Agency to stay financially able to carry out its functions and meet payroll, keep accurate business records, submit accurate bills and claims, file Medicare election and termination notices on time, never charge patients for covered care, and never stop or reduce care to a Medicare or Medicaid patient because the patient cannot pay.","inShort":["Bills and claims must be accurate and match what was documented.","Send every signed election form to billing the same day so the Medicare notice is filed on time.","Never stop or reduce care for a Medicare or Medicaid patient because they cannot pay.","Patients are told before care starts what they may have to pay.","If you see a billing mistake, tell the Administrator the same day."],"primaryCitation":"26 TAC §558.252","citations":["26 TAC §558.252","26 TAC §558.254","26 TAC §558.850(f)","26 TAC §558.243(b)(1)(I)","26 TAC §558.282(f)(2)(C)","26 TAC §558.292(a)(5)"],"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 written policy for accurate billing and insurance claims.","How do you make sure the Notice of Election is filed within 5 calendar days?"],"forms":[],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (26 TAC §558.252; §558.254)","5. Budget and Solvency","6. Telling Patients What They May Owe","7. Medicare Notices and Claims","7.1 Pre-billing checks","8. Corrections, Overpayments and Records","9. Responsibilities and Monitoring","10. References","11. Related Policies and Forms","12. Approval","13. Revision History"],"version":"1.0","sample":false,"pack":"tx-hospice","state":"Texas","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 Hospice","legalName":"Sample Hospice, LLC","logo":null}}