Is a separate application required for a patient with multiple outpatient encounters or inpatient admissions?
Applications for Disability Assistance Medical recipients need only be taken once each month, as a DAM recipient is generally eligible for the entire month. OAC 5101:3-2-07.17 (B)(3) permits a hospital to use a non-DAM HCAP application for 90 days from the date of an initial outpatient service. Any additional outpatient encounter within that time frame may be declared eligible for HCAP based on that application. It is also not necessary to take a new application for an inpatient re-admission so long as the re-admission is within 45 days of the date of the initial admission and it is for the same underlying condition. Eligibility for all other inpatient admissions must be judged separately, based on a patient’s income and family size on the date of admission.
Applications for Disability Assistance (DA) recipients need only be taken once each month, as a DA recipient is generally eligible for the entire month. OAC 5101:3-2-07.17 (B)(3) permits a hospital to apply an approved free care application to any outpatient service delivered up to 90 days from the date of the initial outpatient service. It is also not necessary to take a new application for an inpatient re-admission so long as the re-admission is within 45 days of the date of the initial admission and it is for the same underlying condition. Eligibility for all other inpatient admissions must be judged separately and require new free care applications.
Related Questions
- Should we use the iEXCHANGE Web application or iEXCHANGE IVR system for Precertification of inpatient admissions or outpatient services?
- How does the No Delays Achiever deal with patient journeys that are more complex than Outpatient to Diagnostics to Inpatient?
- Is a separate application required for a patient with multiple outpatient encounters or inpatient admissions?
