Admission Agreement, Informed Consent, and Disclosure of Charges
Sets out how the Agency obtains the patient's informed consent to care and keeps it current, honors a refusal, and tells each patient orally and in writing, before care starts, what Medicare, Michigan Medicaid or other programs are expected to pay, what is not covered, and what the patient may have to pay, using the Home Health Services Agreement and Consent. It applies the Michigan Medicaid rules on billing beneficiaries, payment in full, prior authorization, missed visits and consent to share behavioral health information.
About this policy
- Policy number
- MI-HH-PR-03
- Version
- 1.0
- Main rule
- 42 CFR §484.50(c)(4) and (7)
- Library
- Michigan home health · 57 policies
- Category
- Client rights
- Sections
- 19
In short
- Explain the care and get the signed services agreement and consent at the first visit, before any care.
- Tell the patient, out loud and in writing, what Medicare or Medicaid should pay and what the patient may owe.
- If coverage changes, tell the patient before the next visit.
- A patient may refuse any care. Respect it, explain the risks, record it and tell the clinical manager the same day.
- Never bill a Medicaid patient for a covered service, and never because we missed a prior authorization.
What's inside
19 sections. The full text comes with the One-time Policy Pack.
- Terms of Reference
- 1. Purpose
- 2. Scope
- 3. Definitions
- 4. Policy Statement (42 CFR §484.50(c)(4) and (7))
- 5. Consent at Admission
- 6. Consent During Care
- 7. Refusal of Care
- 8. Telling Patients About Payment
- 9. Medicare Advance Notice
- 10. Michigan Medicaid Beneficiaries
- 11. Keeping the Agreement Current
- 12. Responsibilities
- 13. Records and Compliance Monitoring
- 14. Staff Training
- 15. References
- 16. Related Policies and Forms
- 17. Approval
- 18. Revision History
An inspector may ask
- Show me this patient’s signed services agreement. When was it signed compared with the first visit?
- How did you tell this patient, orally and in writing, what Medicare or Medicaid will pay and what the patient may owe?
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