Payment Guidelines

We will accept Medicare assigned payment as "payment in full" for the services we provide as long as you meet the qualifying requirements and the services are covered by Medicare.

Medicare will act as third-party payor for most, but not all, services of McLeod Health, for qualified patients. Medicare or another third party would not pay home health aide, homemaker, or personal companion costs.

The following items are required for Medicare to pay for your home health care services:

• You are homebound. This means that due to your illness or injury, you are unable to leave your home without a considerable taxing effort and absences are short and infrequent. Trips are usually for medical reasons.
• You have had a recent illness or injury (or worsening of a condition) that requires the care of a Registered Nurse, Physical Therapist, or Speech Therapist.
• You are under the care of a doctor who has ordered the treatment or services we are providing. If the services are not medically necessary and specifically ordered by your doctor, Medicare will not pay for those services.
• Care is provided on an intermittent basis. This means Medicare will not pay for our health care staff to stay with you for an extended period of time. We will only visit you for the length of time it takes to provide the specific treatment ordered by your doctor for a specific episode of illness.

If all of these requirements are met, Medicare will also pay for medically necessary Occupational Therapists, Medical Social Services, Home Health Aides, and approved medical supplies through a bundled service & supply benefit. Our agency will bill Medicare for our services on your behalf.

Please notify the agency immediately if you decide to enroll in a Medicare or private HMO (Health Maintenance Organization) or Hospice. Medicare may not pay for the services we are providing if you are enrolled in an HMO or Hospice.

If services are ordered that the Medicare program does not cover, you will be notified by the agency in advance so that you can make other financial arrangements for the necessary care.

Exceptions to these requirements will be made for private insurance and self-pay patients on a case-by-case basis.

Patient Privacy Policy

Home Health Agency
Outcome of Assessment Information Set (OASIS)

Statement of Patient Privacy Rights (Medicare/Medicaid)

As a home health patient, you have the privacy rights listed below.

You have the right to know why we need to ask you questions. We are required by law to collect health information to make sure: (1) you receive quality health care, and (2) payment for Medicare and Medicaid patients is correct.

You have the right to have your personal health care information kept confidential. You may be asked to tell us information about yourself so that we know which home health services will be best for you. We keep anything we learn about you confidential. This means only those who are legally authorized to know, or who have a medical need to know, will see your personal health information.

You have the right to refuse to answer questions. We may need your help in collecting your health information. If you choose not to answer, we will fill in the information as best we can. You do not have to answer every question to receive services.

You have the right to look at your personal health information. We know how important it is that the information we collect about you is correct. If you think we made a mistake, ask us to correct it.

If you are not satisfied with our response, you can ask the Health Care Financing Administration, the federal Medicare and Medicaid agency, to correct your information.

You can ask the Health Care Financing Administration to see, review, copy, or correct your personal health information, which that federal agency maintains in its HHA OASIS System of Records.

For Patients Who DO NOT Have Medicare or Medicaid Coverage:

As a home health patient, there are a few things that you need to know about our collection of your personal health care information.

Federal and State governments oversee home health care to be sure that we furnish quality home health care services and that you, in particular, get quality home health care services.

We need to ask you questions because we are required by law to collect health information to make sure that you get quality health care services.

We will make your information anonymous. That way, the Health Care Financing Administration, the federal agency that oversees this home health agency, cannot know the information is about you.

We keep anything we learn about you confidential.

This is a Medicare & Medicaid Approved Notice