Common use of Missed Visits Clause in Contracts

Missed Visits. (i) Provider must develop a back-up plan for each Covered Person to be implemented during missed visits, or when otherwise necessary. For purposes of this section, “missed visit,” refers to a period of one or more hours that a staff member of Provider does not furnish the home health service that a Covered Person is authorized to receive and which has been implemented. A missed visit may be due to exigent circumstances beyond any party’s control. It may also be due to a fault of Provider, the staff member, Subcontractor or Health Plan. It may also be due to a fault of the Covered Person. For example, the Covered Person refuses to allow the staff member to enter the home or to remain there after beginning work; the staff member suspects or witnesses unlawful activity in the home; or, the environment in the Covered Person’s home is such that the staff member fears for their personal safety. (ii) When Provider is notified before a missed visit occurs or as it is occurring, Provider must contact the Covered Person and implement the back-up plan or offer a suitable alternative service. Provider must report all missed visits to Subcontractor and/or Health Plan in writing within three calendar days of the missed visit. This report must be submitted on a Subcontractor and/or Health Plan-approved form, which captures all of the information the Subcontractor or Health Plan requires, including, but not limited to, the following: the identity of the Covered Person; the type of service involved; the date of the missed visit; the cause(s); and, what corrective action was taken to mitigate the cause(s) of the missed visit. Provider must ensure that the staff member enters notes about the circumstances of a missed visit in every instance in which notes are possible.

Missed Visits. (ia) Provider must develop a back-up plan for each Covered Person to be implemented during missed visits, or when otherwise necessary. For purposes of this section, “missed visit,” refers to a period of one or more hours that a staff member of Provider does not furnish the home health service that a Covered Person is authorized to receive and which has been implemented. A missed visit may be due to exigent circumstances beyond any party’s control. It may also be due to a fault of Provider, the staff member, Subcontractor or Health PlanUnited. It may also be due to a fault of the Covered Person. For example, the Covered Person refuses to allow the staff member to enter the home or to remain there after beginning work; the staff member suspects or witnesses unlawful activity in the home; or, the environment in the Covered Person’s home is such that the staff member fears for their personal safety. (iib) When Provider is notified before a missed visit occurs or as it is occurring, Provider must contact the Covered Person and implement the back-up plan or offer a suitable alternative service. Provider must report all missed visits to Subcontractor and/or Health Plan United in writing within three calendar days of the missed visit. This report must be submitted on a Subcontractor and/or Health PlanUnited-approved form, which captures all of the information the Subcontractor or Health Plan United requires, including, but not limited to, the following: the identity of the Covered Person; the type of service involved; the date of the missed visit; the cause(s); and, what corrective action was taken to mitigate the cause(s) of the missed visit. Provider must ensure that the staff member enters notes about the circumstances of a missed visit in every instance in which notes are possible.