26 Tex. Admin. Code § 211.211 - Billing and Payment
(a) The method of
payment is a unit of authorized service and is defined as half a day. One unit
of service constitutes three hours but less than six hours of covered services
provided by the DAHS facility. Six hours or more of service constitutes two
units of service. Time spent in approved transportation provided by the DAHS
facility shall be counted in the unit of service.
(b) The DAHS facility is not entitled to
payment if:
(1) the DAHS facility fails to
submit prior approval forms or supporting documentation to the regional nurse
within the required time frames for DAHS facility initiated
referrals;
(2) the DAHS facility
did not maintain the staff-client ratio for one or more days;
(3) the DAHS facility exceeded its license
capacity; or
(4) the DAHS
facility's monthly claims do not correspond to the DAHS facility's service
authorizations and DADS' Daily Attendance/Daily Transportation Record
form.
Notes
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