Section 2060.345  Service Fees and Policy

a)         The organization shall establish one fee schedule that specifies the standard fee charged for each treatment, intervention, or support service (e.g., toxicology screens, administrative functions such as copying, etc.) and a policy regarding billing and collection.

b)         The fee schedule shall be made available to each person receiving the service and signed and dated by that person.  The fee schedule shall indicate the estimated amount the person will be responsible to pay, along with any relevant payment schedule for each service.

c)         The fee schedule shall be updated annually or whenever there are changes that impact the amount of payment due from the person.

d)         The organization shall ensure that the person is made aware of benefits that they might qualify for that could subsidize the cost of their services.  This includes identification of any third-party payment benefits, including Medicaid, other health insurance or State or federal funds, and how to make application for them.  The organization shall also ensure that the person is made aware of any third-party billing that will be utilized and informed of the right to opt out of this type of billing and, instead, self-pay for the service.

e)         Organizations that do not have certifications or contracts with third-party payors for which the person has or is eligible for coverage or benefit shall make referral options available to such person for services from alternate organizations who have the applicable coverage.  All referrals shall be made as specified in Section 2060.380.

f)         Billing or documentation errors made by the organization shall not result in additional cost to the individual receiving the service.