Policy Manual sample

MDT Home Health Care Agency, Inc. PATIENT CHARGES FOR OUR SERVICES (subject to change) POLICY: · The agency charges a fee for service provided to its patients · The Administrator and Director of Nursing, Clinical Manager establishes a recommended charge for each service based upon current industry conditions, market analysis, cost analysis, and budget · These recommendations are presented to the Board of Director for final approval · Any changes, including managed care contract discounts, or exceptions to charges, may be made only by permission of the Administrator in consultation with the President. General Rules: All Charges for our Services are conveying to the patient trough our Admission Package, with full information including in the Patient Handbook, and in the Agreement signed by the patient or patient’s representative. To the Public and Referral sources trough this Policy that is public and delivery to them upon request. If the patients are admitted through medicare no charges will be expected. We will request that all payments go directly to the Agency. The patient will be explained trough our Service Agreement that to receive Medical covered home care services, they must meet the qualifying criteria as outlined under information of Medicare coverage criteria statement contained in their home folder, if their home care services conform to this rule, their Medicare home care services should generally be covered without liability for payment. If services should be determined as denied or non-covered by Medicare, then the patient will be notified via letter and payment will be at the discretion of our agency. The patient must understand that he/she may be financially responsible for charges not paid under any assignment, charges will not exceed the agency's regular Medicare charges ($100.00 per visit). The patient will be informed that all applying payment is under the title XVIII and/or XIX of the social security act. He/she must authorize the release of all records required to act on this request. I the patients are admitted through medicaid their responsibilities is $ 2.00 co-pay per visit with a maximum of one co-payment per day, that will be colleted at the discretion of our Agency. I they are admitted through HMO, Commercial Insurance, Medicare insurance as a secondary payer. The charges will be determined through third party contracts that will be explained to all patients prior to star the services. I they are admitted through private pay, the charges are specified in the private pay agreement signed by the patient in our Service Agreement (part II). The following quotes are only guidelines and are subject to changes at any time. (The information is included in the Client Admission handbook) SERVICE MEDICAID MEDICARE/PRIVATE RN 45.00 100.00 LPN 35.00 95.00 HHA 25.00 65.00 THERAPISTS 45.00 100.00 SOCIAL SERVICES N/A 100.00 Present and Projected Home Health Agency Overall Plan and Budget F-7