Consent for Care, Service Agreement, and Disclosure of Payment Liability
Sets out how the Agency obtains and records the patient’s consent to care and the service agreement (22 CCR §74735(a)(7)); how the patient is told, before care starts, the disciplines and visit frequency proposed and, orally and in writing, what Medicare, Medi-Cal, or other payers may pay and what the patient may have to pay (22 CCR §74743(c), (e)); how changes in that information are given (no later than 30 calendar days under §74743(f), and before the next visit if Medicare-certified); refusal of care; and the advance written notices CMS requires before non-covered care or a reduction or end of care.
- Policy number
- CA-HH-PR-03
- Version
- 1.0
- Main rule
- 22 CCR §74743(e)
- Library
- California home health · 58 policies
- Category
- Client rights
- Sections
- 20
In short
- Before any care, explain who will visit, how often, and what the care is for, and get the patient’s signed consent.
- Before care starts, tell the patient by voice and in writing what Medicare, Medi-Cal, or insurance should pay and what the patient may owe.
- Tell the patient before any change in the plan of care is made.
- If coverage or charges change, tell the office the same day. The patient must be told by voice and in writing, before the next visit if possible and never later than 30 days.
- A patient can refuse any care. Explain what may happen, write it down, and tell the nurse supervisor.
What's inside
20 sections. The full text comes with the One-time Policy Pack.
- Terms of Reference
- 1. Purpose
- 2. Scope
- 3. Definitions
- 4. Policy Statement (22 CCR §74743(e))
- 5. Before the First Visit
- 6. Consent and the Service Agreement at the First Visit
- 7. Consent to Specific Procedures
- 8. Refusal of Care
- 9. Changes in Care
- 10. Changes in Payment or Charges
- 11. Advance Notices to Medicare Beneficiaries
- 12. Medi-Cal and Other Payers
- 13. Responsibilities
- 14. Records and Compliance Monitoring
- 15. Staff Training
- 16. References
- 17. Related Policies and Forms
- 18. Approval
- 19. Revision History
An inspector may ask
- Show me the signed consent or service authorization form in this record.
- How did you tell this patient, before care began, what Medicare or Medi-Cal would pay and what the patient might have to pay?
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