Patient liability definition
Patient liability means the individual's financial obligation toward the medicaid cost of care. Patient liability shall be satisfied in accordance with rule 5160:1-6-07.1 of the Administrative Code.
Patient liability. The amount of a Covered Person’s income, as determined by the Division of TennCare, to be collected each month to help pay for the Covered Person’s Long-Term Services and Supports.
Examples of Patient liability in a sentence
Patient liability is imposed in accordance with 42 C.F.R. § 435.725.
Patient liability applies to members who reside in a nursing home or Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF-IID) for 30 or more consecutive days or are likely to reside there for 30 or more consecutive days.
Patient liability shall be applied as an offset against the amount Medicaid would otherwise reimburse for the claim.
Patient liability income for a participant, whose spouse is also in long-term care, choosing the community property method, is one-half (1/2) his share of the couple’s community income, plus his own separate income.
Patient liability balances where an ABN is signed and on file will be processed according to self-pay guidelines.
More Definitions of Patient liability
Patient liability. The amount of an enrollee’s income, as determined by the State, to be collected each month to help pay for the enrollee’s long-term care services. Pharmacy Benefits Manager (PBM) – An entity responsible for the provision and administration of pharmacy services. Plan of Care – As it pertains to Population Health the plan of care is a personalized plan to meet a member’s specific needs and contains the following elements: prioritized goals that consider member and care giver needs which are documented; a time frame for re-evaluation; the resources to be utilized; a plan for continuity of care, including transition of care and transfers; and uses a collaborative approach including family participation. The plan of care is built upon the information collected from the health assessment to actively engage the member in developing goals and identifying a course of action to respond to the members’ needs. The goals and actions in the plan of care must address medical, social, educational, and other services needed by the member. Providing educational materials alone does not meet the intent of this factor.
Patient liability means the financial amount an individual is required to contribute toward cost of care in order to maintain Medicaid eligibility.
Patient liability. The amount of an enrollee’s income, as determined by the State, to be collected each month to help pay for the enrollee’s long-term care services. Person-Centered Support Plan (PCSP) – As it pertains to CHOICES and ECF CHOICES, the PCSP is a written plan developed by the Support Coordinator or Care Coordinator in accordance with person- centered planning requirements set forth in federal regulation, and in TennCare policies and protocols, using a person-centered planning process that accurately documents the member’s strengths, needs, goals, lifestyle preferences and other preferences and outlines the services and supports that will be provided to the member to help them achieve their preferred lifestyle and goals, and to meet their identified unmet needs (after considering the availability and role of unpaid supports provided by family members and other natural supports) through paid services provided by the member’s MCO and other payor sources. The person-centered planning process is directed by the member with long-term support needs and may include a representative whom the member has freely chosen to assist the member with decision-making, and others chosen by the member to contribute to the process. If the member has a guardian or conservator, the member shall lead the planning process to the maximum extent possible, and the guardian or conservator shall have a participatory role as needed and defined by the individual, except as explicitly defined under State law and the order of guardianship or conservatorship. Any decisions made on the member’s behalf should be made using principles of substituted judgment and supported decision- making. This planning process, and the resulting PCSP, will assist the member in achieving a personally defined lifestyle and outcomes in the most integrated community setting appropriate, ensure delivery of services in a manner that reflects personal preferences and choices, and contribute to the assurance of health, welfare, and personal growth. Services in CHOICES and ECF CHOICES shall be authorized, provided, and reimbursed only as specified in the PCSP. Pharmacy Benefits Manager (PBM) – An entity responsible for the provision and administration of pharmacy services. Plan of Care – As it pertains to Population Health the plan of care is a personalized plan to meet a member’s specific needs and contains the following elements: prioritized goals that consider member and care giver needs which are documented; a time fram...
Patient liability means the individual's financial obligation toward the medical cost of care." Ohio Adm.Code 5101:1-39-24(B)(22). The procedure for determining an individual's patient liability is set forth in Ohio Adm.Code 5101:1-39-24(C)(2), which states:
Patient liability. The amount of an enrollee’s income, as determined by DHS, to be collected each month to help pay for the enrollee’s long-term care services. Pharmacy Benefits Manager (PBM) – An entity responsible for the provision and administration of pharmacy services.
Patient liability means all payments owed to Hospital by a Registered Patient, such as deductibles, co-payments, payments for elective procedures and all other payments that are not covered by third-party insurers.