Minnesota Administrative Rules
Agency 196 - Human Services Department
Chapter 9515 - STATE HOSPITAL ADMINISTRATION
REIMBURSEMENT FOR COST OF CARE OF PATIENTS AND RESIDENTS IN STATE FACILITIES
Part 9515.1500 - FINANCIAL INTERVIEW

A. inform the person that he or she may choose an individual to assist in the determination process and any other contact with the department by authorizing such assistance in writing;

B. provide the person with an informational pamphlet on cost of care and review with the person how the department determines the charges for the client's cost of care;

C. inform the person that financial information obtained from the person will not be released without the person's written consent except pursuant to Minnesota Statutes, chapter 13;

D. inform the person of county, state, and federal financial programs which may assist in paying the cost of care and meeting personal and family needs;

E. inform the person of the legal obligation to provide sufficient information, required documents, and proof necessary to determine ability to pay and of the consequences of the failure to do so;

F. provide the person the following forms which the department uses to investigate the person's financial resources: the financial information form, the insurance claim and assignment of insurance benefits form, and the form or forms consenting to the release of information necessary to obtain or verify information about the person's resources; and

G. request the person to complete and sign the forms provided by the department and to provide verification of financial information.