Referral Intake, Acceptance-to-Service, and Public Information About Services
Sets out how the Agency receives and screens every referral, applies one written acceptance-to-service policy to every prospective patient (anticipated needs, caseload and case mix, staffing levels, and staff skills and competencies), records the decision, tells the referral source and the patient the outcome, refers onward when it cannot accept, and keeps accurate public information about its services and their limits. It applies the Michigan Medicaid rules on service setting, health plan authorization, evaluation visits and selective acceptance.
- Policy number
- MI-HH-ADM-01
- Version
- 1.0
- Main rule
- 42 CFR §484.105(i)
- Library
- Michigan home health · 57 policies
- Category
- Service delivery
- Sections
- 21
In short
- Write down every referral at once, with the date and time, and pass it to intake.
- Only the clinical manager decides whether we accept a referral, using the same written criteria every time.
- Never promise a service before the referral is accepted.
- If we cannot accept, tell the referral source and the person the same day and offer other agencies.
- Public information about our services must be accurate and is reviewed at least once a year.
What's inside
21 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 §484.105(i))
- 5. Receiving a Referral
- 6. The Acceptance Decision
- 7. After the Decision
- 7.1 Referral Accepted
- 7.2 Referral Not Accepted
- 7.3 Persons Already Under Another Provider’s Care
- 8. Michigan Medicaid and Health Plan Referrals
- 9. Public Information About Services
- 10. Annual Review of This Policy
- 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 your acceptance-to-service policy. When was it last reviewed, and by whom?
- Walk me through what happened to the last three referrals you did not accept. How was each decision made and recorded?
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