Care Regardless of Ability to Pay, Billing Integrity and Notices to Medicare
Makes sure no terminally ill patient is refused, reduced or discharged because of inability to pay, that patients receive a description of services, levels of care and charges, and that billing is accurate and timely, including the Medicare notice of election and notice of termination or revocation within 5 calendar days, inpatient and aggregate caps, and record retention for claims.
About this policy
- Policy number
- GA-HSP-FIN-01
- Version
- 1.0
- Main rule
- Ga. Comp. R. & Regs. 111-8-37-.07(5)(i)
- Library
- Georgia hospice · 60 policies
- Category
- Business
- Sections
- 16
In short
- No terminally ill patient is refused care, given less care or discharged because they cannot pay.
- Patients get a written description of services, levels of care and any charges before admission.
- Tell billing the same day a patient elects hospice, revokes or is discharged. Medicare notices are due within 5 calendar days.
- Document every visit fully and accurately. Claims are based only on your signed documentation.
What's inside
16 sections. The full text comes with the One-time Policy Pack.
- Terms of Reference
- 1. Purpose
- 2. Scope
- 3. Definitions
- 4. Policy Statement (Ga. Comp. R. & Regs. 111-8-37-.07(5)(i); 42 CFR §418.100(d))
- 5. Care Regardless of Ability to Pay
- 6. Information About Charges
- 7. Medicare Notices and Claims
- 8. Levels of Care and Caps
- 9. Billing Accuracy
- 10. Responsibilities
- 11. Records and Compliance Monitoring
- 12. References
- 13. Related Policies and Forms
- 14. Approval
- 15. Revision History
An inspector may ask
- Have you ever refused or discharged a patient because of inability to pay?
- Where does a patient learn about charges for any service not covered?
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