The service plan should have the published rate for the service. This is the agency charge. If there is a contract with insurance company to bill a lower rate or bill DHS a lower rate, that is ok-if agreed to by both parties. You are informing your client of the charge and informing the client the payer has a negotiated rate. You have a copy of the contract that shows a different rate. Jeanette

Jeanette Mefford, MPH, BSN

Mefford, Knutson & Associates, Inc.

Home Health Consultant

2950 Metro Drive, #301

Minneapolis, MN 55425

Phone: 612-869-8011

Fax: 952-500-8240

From: comprehensivecompliance@list.mnhomecare.org <comprehensivecompliance@list.mnhomecare.org> On Behalf Of Finch, Dori
Sent: Wednesday, November 8, 2023 1:06 PM
To: comprehensivecompliance@list.mnhomecare.org
Subject: RE: Service Plan Question

Thank you Jeanette for the reply!

The question I had was the agency has a publicized fee schedule

But the charges that they are billing to the payment source does not match the fee schedule

Can they have arrangements with payer sources that are lower than their set fee schedule but are different than what is included in the Service Plan?

Sent from my T-Mobile 4G LTE Device

-------- Original message --------

From: Jeanette Mefford <jmefford@mkaonline.com>

Date: 11/8/23 12:54 PM (GMT-06:00)

To: comprehensivecompliance@list.mnhomecare.org

Subject: RE: Service Plan Question

CAUTION: This email originated from outside the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe.

The agency is responsible for letting the client know the charges for services regardless of who is paying the bill. Clients can be informed that payers don’t necessarily pay that amount but that is the charge. In a Medicare agency visit rates should be published. If an agency also does hourly services or private pay services- that can be added to rate sheet or separate sheet for those services. Having published rates does not prevent agencies from having arrangements with payers for different rates. (usually would be lower than published rates). Jeanette

Jeanette Mefford, MPH, BSN

Mefford, Knutson & Associates, Inc.

Home Health Consultant

2950 Metro Drive, #301

Minneapolis, MN 55425

Phone: 612-869-8011

Fax: 952-500-8240

From: comprehensivecompliance@list.mnhomecare.org <comprehensivecompliance@list.mnhomecare.org> On Behalf Of Finch, Dori
Sent: Wednesday, November 8, 2023 10:36 AM
To: comprehensivecompliance@list.mnhomecare.org
Subject: Service Plan Question

If an agency includes their fee schedule rate in their service plan with the client but a different rate is billed to the payment source are they out of compliance with the MN service plan requirements?

Thank you!

Dori Finch

Sent from my T-Mobile 4G LTE Device

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