Billing, Claims, Signed Treatment Orders Before Billing, and Overpayments
Requires every claim to be for services actually provided, ordered, documented, and covered, requires treatment orders to be signed before a claim for skilled services is submitted, keeps charges to patients to those disclosed in the service agreement, and sets the 60-day rule for reporting and returning overpayments.
About this policy
- Policy number
- FL-HH-BUS-02
- Version
- 1.0
- Main rule
- s. 400.487(2), F.S.
- Library
- Florida home health · 57 policies
- Category
- Business
- Sections
- 18
In short
- We bill only for visits that really happened and are documented and ordered.
- Skilled visits are not billed until the treatment orders are signed.
- Write your visit note at the time of the visit. Never chart ahead or record something you did not see.
- Tell your supervisor the same day about any missed visit. Missed visits are not billed.
- If we find we were paid too much, we pay it back.
What's inside
18 sections. The full text comes with the One-time Policy Pack.
- Terms of Reference
- 1. Purpose
- 2. Scope
- 3. Definitions
- 4. Policy Statement (s. 400.487(2), F.S.)
- 5. Conditions Before Any Claim Is Submitted
- 6. Prohibited Billing Practices
- 7. Charges to Patients
- 8. Billing Reviews
- 9. Overpayments
- 10. Medicaid Records
- 11. Responsibilities
- 12. Records and Compliance Monitoring
- 13. Staff Training
- 14. References
- 15. Related Policies and Forms
- 16. Approval
- 17. Revision History
An inspector may ask
- Show me how you make sure the treatment orders are signed before you submit a claim for skilled services.
- How do you check that every billed visit actually happened and is documented?
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