77 Ill. Adm. Code 2060.345
Service Fees and Policy
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.