Service Agreement, Informed Consent, and Disclosure of Charges
Sets out the written service agreement each patient signs before care begins, informed consent and the right to refuse, consent to release information, the oral and written explanation of expected payment and charges before care is initiated, advance written notice before possibly non-covered care and before care is reduced or ended (with the Medicare notices for certified agencies), and the Ohio Medicaid rule that Medicaid payment is payment in full.
About this policy
- Policy number
- OH-HH-PR-03
- Version
- 1.0
- Main rule
- 42 CFR §484.50(c)(7)
- Library
- Ohio home health · 59 policies
- Category
- Client rights
- Sections
- 19
In short
- Before care starts, the patient signs the service agreement and consent.
- Tell the patient, in person and in writing, what Medicare, Medicaid or another payer is expected to pay and what they may have to pay.
- If payment information changes, tell the patient as soon as possible, before the next visit.
- Give written notice before a service that may not be covered, and before care is reduced or ended.
- Never ask an Ohio Medicaid patient or family to pay for a covered service.
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)(7))
- 5. Before the First Visit: Verifying Payment
- 6. The Service Agreement
- 7. Obtaining Informed Consent
- 8. Consent to Release of Information
- 9. Telling the Patient About Payment and Charges
- 10. Notices Before Non-Covered Care and Before Reducing or Ending Care
- 11. Changes to the Agreement and Withdrawal of Consent
- 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 the signed service agreement and consent for this patient. When was it signed compared with the first visit?
- How did you tell this patient, orally and in writing, what Medicare or Medicaid would pay and what they might owe?
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