§ 97265. Definition of Data Element for ED and AS--Expected Source of Payment.
22 CA ADC § 97265Barclays Official California Code of Regulations
22 CCR § 97265
§ 97265. Definition of Data Element for ED and AS--Expected Source of Payment.
The patient's expected source of payment, defined as the type of entity or organization which is expected to pay or did pay the greatest share of the patient's bill, shall be reported using the following categories:
(b) Other Non-Federal Programs. Include any form of payment from local, county, or state government agencies. Include payments from county funds, whether from county general funds or from other funds used to support county health programs. Include County Indigent Programs, County Medical Services Program (CMSP), California Healthcare for Indigent Program (CHIP), County Children's Health Initiative Program (C-CHIP), and Short-Doyle funds. Also include the State Children's Health Insurance Program (SCHIP), Managed Risk Medical Insurance Board (MRMIB), Healthy Families Program (HFP), and Access for Infants and Mothers (AIM).
(l) Health Maintenance Organization (HMO). Report HMO payors. Include Knox-Keene licensed plans as well as out of State HMO plans. No Plan Code Number or Plan Code Name is required for ED or AS records. Report Medicare payments covered under an HMO arrangement as Health Maintenance Organization (HMO) Medicare Risk. Report Medi-Cal payments covered under an HMO arrangement as Medicaid.
(q) Title V. Defined by the Federal Medicare Act (PL 89-97) for Maternal and Child Health. Title V of the Social Security Act is administered by the Health Resources and Services Administration, Public Health Service, Department of Health and Human Services. Include a Maternal and Child Health program payment that is not covered under Medicaid (Medi-Cal). California Children Services (CCS) payments should be reported here.
Credits
Note: Authority cited: Section 128810, Health and Safety Code. Reference: Sections 128736 and 128737, Health and Safety Code.
History
1. New section filed 5-5-2005; operative 5-5-2005 pursuant to Government Code section 11343.4 (Register 2005, No. 18).
This database is current through 5/10/24 Register 2024, No. 19.
Cal. Admin. Code tit. 22, § 97265, 22 CA ADC § 97265
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