Health Care Referral Form,

	*Insurance, Medicaid and Claim Processing*

	If a client is covered by private insurance, Medicaid, auto insurance, workman's compensation, private foundation, HMO, Medicare or any other program, Loving Hands will assist you in determining available benefits. Loving Hands will verify coverage and accept assignment of benefits to help relieve you of the tedious paperwork. We will also fulfill request by physicians, insurance companies or responsible parties for processing documentation. Complete insurance verification and financial counseling for clients and families are offered to allow for a maximum usage of available resources.

	Billing

	Billing rates are arrange between the client and Loving Hands. Personnel are paid directly by Loving Hands, and are not prepared to discuss cost or accept cash advances or gratuities. Any questions regarding their reimbursement should be directed to our office. Responsible parties are billed by mail on a weekly basis at the agreed upon rate, previously negotiated between Loving Hands and the client. Any paperwork needed to accompany each bill must be discussed prior to the billing cycles. Payment is expected upon receipt of invoice.

	Medicaid Certified by the Commission on Accreditation for Home Care Members & Affiliation of:

	National Association of Home Care Home Health Assembly of New Jersey Home Health Assembly of New York National Hospice Organization in Home Care New Jersey League of Nursing License Practical Nurses Association Health and Welfare Council New Jersey Association of Rehabilitation New Jersey State Nurses Association New Jersey Head Injury Association, Inc. American Heart Association American Cancer Society Multiple Sclerosis Society The Special Olympics U.S. Organized Labor Preferred Home Care Provider Corporate Research Sponsor to Memorial Sloan-Kettering Cancer Center

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