How will providers determine if a person is eligible for the uncompensated care pool?
OMH anticipates that visits can be counted toward indigent care volume if they meet the following conditions: • Self pay, including partial pay or no pay visits (does not include partial payment associated with co-pays or deductibles). • Required or optional mental health clinic procedures (as defined in OMH regulations) provided but not covered under a clinics agreement with an insurer. The service must be provided by a practitioner qualified to deliver the service under state regulations. • Unreimbursed clinic visits/procedures appropriately provided to an insured recipient by a clinic staff member not approved for payment by a third party payor in contract with the clinic. The provider must document that the clinic or recipient received a denial of payment. • Unreimbursed clinic visits/procedures appropriately provided to an insured recipient by a clinic staff member when the procedure is not reimbursed by a third party payer not in contract with the clinic. Only visits for which th
