Medicaid Clients. CHR participates with Medicaid. However, if you are on a spend-down you will be responsible for payment until your spend-down is met. Medicare Clients: CHR participates with Medicare. After your yearly deductible is met, you will typically be responsible for 20% of charges that are considered your co-insurance. If you have Medicaid as a secondary insurance, Medicaid will be billed for you. CHR reviews published charges every year. If you have any questions regarding our published charges, please feel free to contact the front desk. I understand that I will be responsible for all patient responsibility according to how my insurance company processes my claim and /or full payment if I am uninsured. I will be sure to notify CHR of any changes in my insurance immediately. ACUERDO DE XXXXXXX Y POLÍTICA DE FINANCIACIÓN DEL CLIENTE Le agradecemos que nos haya elegido como sus proveedores de atención médica. Estamos comprometidos con el éxito de su tratamiento y esperamos que su experiencia con CHR sea una positiva. Por favor entienda que el pago de su factura se considera parte de su tratamiento. Lo siguiente es una declaración de nuestra Política de Financiación. - Todos los clientes deben completar nuestro formulario de autorización de información al momento de la admisión. - El pago por los servicios, incluyendo el cargo completo si no tiene seguro, y los copagos, coseguro, planes de pago, etc. Se deben pagar al momento de registrarse para su visita. - Si en algún momento incurre en un saldo vencido, en su próxima visita debea’ pagar el pago completo - Si no cumple con dos copagos o dos planes de pago, no se le dará ma’s citas hasta que hayamos recibido su pago. - Si se va de la agencia con un saldo vencido, se espera que lo pague antes de poder volver a recibir servicios. - Usted es responsable de actualizar inmediatamente a CHR en relación con cualquier cambio en su seguro. De no hacerlo usted podría debernos algún pago. - Aceptamos efectivo, cheques y tarjetas de crédito/cargo en todos los centros. Clientes comercialmente asegurados: CHR facturará a su seguro como una cortesía. Usted es responsable de conocer sus beneficios de seguro de salud mental. CHR verificará su elegibilidad y cobrará el pago según su elegibilidad. Sin embargo, una vez que su seguro tramite su reclamación, se le cobrará por cualquier responsabilidad de pago adicional del paciente que se deba de acuerdo a su seguro. La responsabilidad del paciente es pagadera en el momento del servicio...

Medicaid Clients. The provider at his or her discretion may terminate you as a client for two no-shows or cancellations that occur back to back. Legal Services - Court appearance is not a part of the therapy process. This includes testimony as a fact witness, as an expert witness, written or oral deposition, or any type of contact with an attorney. Clients will be charged a minimum of $1500 for 4 hours, 5-8 hours will be a $3,000 charge for providers required to be available to the legal system (court appearance). You will be required to deposit four hundred dollars ($400) with the Center in the form of cash, money order or credit card before a provider will be made available for legal purposes. If your attorney requests/subpoenas files, the fee schedule for copying, etc., will also apply and will need to be paid in advance. By my signature, I have read and understand the above.

Medicaid Clients. The Contractor shall bill Medicaid upon the completion of full and satisfactory dental services. The Contractor will follow Medicaid guidelines, protocols and fee schedule.

Medicaid Clients. The Contractor shall xxxx Medicaid upon the completion of full and satisfactory dental services. The Contractor will follow Medicaid guidelines, protocols and fee schedule.

Medicaid Clients. When a Medicaid client is detained (ITA), or voluntarily seeks inpatient treatment, the servicing facility is required to coordinate care and payment with the MCO (for clients in integrated regions) or the BHO (in on-time-adopter regions), in which the enrollee is assigned to in P1. When a Medicaid client from another state is detained (ITA) and the individual’s state of residence does not cover a service model unique to Washington State, such as Secure Withdrawal Management and Stabilization Services (Secure Detox), the servicing facility is required to coordinate care and payment with the BH-ASO (for integrated regions) or the BHO (in on-time-adopter regions) of the detaining Designated Crisis Responder. Review for revisions October 2019 Non-Medicaid Individuals  ITA o When a Non-Medicaid individual is detained (ITA) outside of their region of residence, the BH- ASO/BHO of the individual’s region of residence is responsible for authorization and payment to the servicing facility. This includes E&T facilities and Community Hospitals.  Voluntary o When a Non-Medicaid individual voluntarily seeks inpatient treatment, outside of their region of residence, the BH-ASO/BHO of the individual’s region of residence is responsible for authorization and payment to the servicing facility. This includes E&T facilities and Community Hospitals. Prior- authorization is required for these services. Approval or denial will be based on medical necessity and available resources.

Medicaid Clients. When a Medicaid client is detained (ITA), or voluntarily seeks inpatient treatment, the servicing facility is required to coordinate care and payment with the MCO, in which the enrollee is assigned to in P1. When a Medicaid client from another state is detained (ITA) and the individual’s state of residence does not cover a service model unique to Washington State, such as Secure Withdrawal Management and Stabilization Services (Secure Detox), the servicing facility is required to coordinate care and payment with the BH-ASO of the detaining Designated Crisis Responder.

Related to Medicaid Clients

Medicaid Enrollment Treatment Grantees shall enroll as a provider with Texas Medicaid and Healthcare Partnership (TMHP) and all Medicaid Managed Care organizations in Grantee’s service region within the first quarter of this procurement term and maintain through the procurement term.
Medicaid If and when the Resident’s assets/funds have fallen below the Medicaid eligibility levels, and the Resident otherwise satisfies the Medicaid eligibility requirements and is not entitled to any other third party coverage, the Resident may be eligible for Medicaid (often referred to as the “payor of last resort”). THE RESIDENT, RESIDENT REPRESENTATIVE AND SPONSOR AGREE TO NOTIFY THE FACILITY AT LEAST THREE (3) MONTHS PRIOR TO THE EXHAUSTION OF THE RESIDENT’S FUNDS (APPROXIMATELY $50,000) AND/OR INSURANCE COVERAGE TO CONFIRM THAT A MEDICAID APPLICATION HAS OR WILL BE SUBMITTED TIMELY AND ENSURE THAT ALL ELIGIBILITY REQUIREMENTS HAVE BEEN MET. THE RESIDENT, RESIDENT REPRESENTATIVE AND/OR SPONSOR AGREE TO PREPARE AND FILE AN APPLICATION FOR MEDICAID BENEFITS PRIOR TO THE EXHAUSTION OF THE RESIDENT’S RESOURCES. Services reimbursed under Medicaid are outlined in Attachment “A” to this Agreement. Once a Medicaid application has been submitted on the Resident’s behalf, the Resident, Sponsor, and Resident Representative agree to pay, to the extent they have access to the Resident’s funds, to the Facility the Resident’s monthly income, which will be owed to the Facility under the Resident’s Medicaid budget. Medicaid recipients are required to pay their Net Available Monthly Income (“NAMI”) to the Facility on a monthly basis as a co-payment obligation as part of the Medicaid rate. A Resident’s NAMI equals his or her income (e.g., Social Security, pension, etc.), less allowed deductions. The Facility has no control over the determination of NAMI amounts, and it is the obligation of the Resident, Resident Representative and/or Sponsor to appeal any disputed NAMI calculation with the appropriate government agency. Once Medicaid eligibility is established, the Resident, Resident Representative and/or Sponsor agree to pay NAMI to the Facility or to arrange to have the income redirected by direct deposit to the Facility and to ensure timely Medicaid recertification. The Resident, Sponsor and Resident Representative agree to provide to the Facility copies of any notices (such as requests for information, budget letters, recertification, denials, etc.) they receive from the Department of Social Services related to the Resident’s Medicaid coverage. Until Medicaid is approved, the Facility may bill the Resident’s account as private pay and the Resident will be responsible for the Facility’s private pay rate. If Medicaid denies coverage, the Resident or the Resident’s authorized representative can appeal such denial; however, payment for any uncovered services will be owed to the Facility at the private pay rate pending the appeal determination. If Medicaid eligibility is established and retroactively covers any period for which private payment has been made, the Facility agrees to refund or credit any amount in excess of the NAMI owed during the covered period.
Primary Care Clinic Employees and each of their covered dependents must individually elect a primary care clinic within the network of providers offered by the plan administrator chosen by the employee. Employees and their dependents may elect to change clinics within their clinic’s Benefit Level as often as the plan administrator permits and as outlined above.
Medicaid Program Parties (applicable to any Party providing services and supports paid for under Vermont’s Medicaid program and Vermont’s Global Commitment to Health Waiver):
Medicare If the Resident meets the eligibility requirements for skilled nursing facility benefits under the Medicare Part A Hospital Insurance Program, the Facility will bill Medicare directly for Part A services provided to the Resident. Medicare will reimburse the Facility a fixed per diem or daily fee based on the Resident’s classification within the Medicare RUG IV guidelines or successor guidelines thereto. If the Resident continues to be eligible, Medicare may provide coverage of up to 100 days of care. The first 20 days of covered services are fully paid by Medicare and the next 80 days (days 21 through 100) of the covered services are paid in part by Medicare and subject to a daily coinsurance amount for which the Resident is responsible. A Resident with Medicare Part B and/or Part D coverage, who subsequently exhausts his/her Part A coverage or no longer needs a skilled level of care under Part A, may still be eligible to receive coverage for certain Part B services (previously included in the Part A payment to the Facility) and/or Part D services when Part A coverage ends. Medicare will terminate coverage for Medicare beneficiaries receiving physical, occupational and/or speech therapy (“therapy services”) if the Resident does not receive therapy for three (3) consecutive days, whether planned or unplanned, for any reason, including illness or refusals, doctor appointments or religious holidays. If such therapy was the basis for Medicare Part A coverage, the Resident would be responsible for the cost of his/her stay, unless another payor source is available. If Medicare denies coverage and denies further payment and/or recoups any payment made to the Facility, the Resident, Resident Representative, and/or Sponsor hereby agree to pay to the Facility any outstanding amounts for unpaid services not covered by other third party payers, subject to applicable federal and state laws and regulations. Such amounts shall be calculated in accordance with the Facility’s applicable prevailing private rates and charges for all basic and additional services provided to the Resident. Except for specifically excluded services, most nursing home services are covered under the consolidated billing requirements for Medicare Part A beneficiaries or under an all-inclusive rate for other third party insurers and managed care organizations (MCOs). Under these requirements, the Facility is responsible for furnishing directly, or arranging for, the services for its residents covered by Medicare Part A and MCOs. When not directly providing services, the Facility is required to enter into arrangements with outside providers and must exercise professional responsibility and control over the arranged-for services. All services that the Resident requires must be provided by the Facility or an outside provider approved by the Facility. Before obtaining any services outside of the Facility, the Resident must consult the Facility. While the Resident has the right to choose a health care provider, the Resident understands that by selecting the Facility, the Resident has effectively exercised his/her right of free choice with respect to the entire package of services for which the Facility is responsible under the consolidated billing and third party billing requirements. The Resident agrees that he/she will not arrange for the provision of ancillary services unless the Resident has obtained prior approval from the Facility. MEDICARE PART A, MANAGED CARE, AND THIRD-PARTY INSURANCE
Subcontracting for Medicaid Services Notwithstanding any permitted subcontracting of services to be performed under this Agreement, Party shall remain responsible for ensuring that this Agreement is fully performed according to its terms, that subcontractor remains in compliance with the terms hereof, and that subcontractor complies with all state and federal laws and regulations relating to the Medicaid program in Vermont. Subcontracts, and any service provider agreements entered into by Party in connection with the performance of this Agreement, must clearly specify in writing the responsibilities of the subcontractor or other service provider and Party must retain the authority to revoke its subcontract or service provider agreement or to impose other sanctions if the performance of the subcontractor or service provider is inadequate or if its performance deviates from any requirement of this Agreement. Party shall make available on request all contracts, subcontracts and service provider agreements between the Party, subcontractors and other service providers to the Agency of Human Services and any of its departments as well as to the Center for Medicare and Medicaid Services.
Extended Health Care Coverage A) The Employer shall pay one hundred percent (100%) of the monthly premiums for extended health care coverage for regular employees and their eligible dependents (including common-law spouses) under the Pacific Blue Cross Plan, or any other plan mutually acceptable to the Union and the Employer (See also Appendix “I”). The plan benefits shall be expanded to include:
Child Care Leave (a) An employee who is the natural or adoptive parent shall be granted, upon request in writing, child care leave without pay for a period of up to thirty-seven (37) weeks.

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