Health Care Responsibility Act (HCRA) Handbook
Table of Contents
[
403.7 kB
]
Chapters
-
Background and Overview
[
306.3 kB
]
-
County, Hospital, and Agency
Program Administration
[
208.6 kB
]
-
Covered Services
Emergency Care
[
191.3 kB
]
-
Application Process
[
258.7 kB
]
-
Eligibility Determination Process
[
278.6 kB
]
-
Claims Processing
[
283.2 kB
]
-
Appeal Process
[
173.9 kB
]
Appendices
-
Definitions
[
29.6 kB
]
-
Monthly Caseload and Appeals Report
[
182.7 kB
]
-
HCRA Quarterly Financial Report
[
59 kB
]
- Out-of-County Charity Care Report
Page 1 [
116.3 kB
]
-
Sample Participation Agreement
[
52.2 kB
]
-
Notification of Eligibility, AHCA Form 5220-0002
[
67.6 kB
]
-
Health Care Assistance Application, AHCA Form
[
90 kB
]
5220-0001 -
UB-04 (CMS-1450) Claim Completion Instructions
[
47.7 kB
]
-
Itemized Paid Claims
[
48.3 kB
]
-
HCRA Income Limits
[
67.6 kB
]
(100% FPL)
-
HCRA Spend-down Provision Income Limits
[
67.9 kB
]
(150%)
