Fla. Admin. Code Ann. R. 69O-153.004 - Disclosure of Agreements

A health care provider shall disclose a pre-provision of services agreement by one of the following methods:

(1) Attaching a copy of the agreement to the claim form;

(2) Attaching a statement that discloses the agreement and the specific terms thereof;

(3) Attaching a copy of the policy which provides for the waiver of all or some portion of a deductible or co-payment for employees of the hospital and others and a representation that the waiver is authorized by the policy as to that provider;

(4) Disclosure on the Office's approved uniform claim form when modified to effectuate such disclosure in a uniform manner as to all claims.

Notes

Fla. Admin. Code Ann. R. 69O-153.004

Specific Authority 626.9611, 641.36 FS. Law Implemented 624.307(1), 626.9541(1)(u), 641.3903(11) FS.

New 2-28-90, Formerly 4-86.004, 4-153.004.