HOPE Guidance Manual v1.02, Item A0700

Timepoint(s) Item Completed

Admission (ADM)

HOPE Update Visit 1 (HUV1)

HOPE Update Visit 2 (HUV2)

Discharge (DC)

Item-Specific Instructions

• Enter the Medicaid number, if the patient is a Medicaid recipient. Enter one number per box,

beginning in the left-most box.

o Enter a “+” in the left-most box if the Medicaid number is pending.

o If the patient is not a Medicaid recipient, enter “N” in the left-most box.

o Confirm that the patient’s legal name on the record matches the patient’s legal name on the Medicaid

card.

o If the patient refuses to supply his or her Medicaid number or the Medicaid number is unknown,

leave A0700 blank.

Coding Tips

• Check the patient’s Medicaid card, admission or transfer records, or hospice clinical record.

• The Medicaid Number entered in A0700 is not intended to reflect the patient’s payer source. For the

purposes of HOPE item completion, the Medicaid Number is used for patient identification purposes

only.

• If the patient has a Medicaid Number, enter it in A0700, even if Medicaid is not a payer or is a

secondary payer.

• If the hospice is notified after the record has been submitted that the patient does have a Medicaid

number, include it on the next record.

o Including the Medicaid number on the next HOPE record at a later date does not require a

Modification Request to the original HOPE-Admission record.

o For instance, if the Medicaid number is received after submission of the HOPE-Admission record,

include the patient’s Medicaid number on the next HOPE record, such as HUV1, HUV2, or the

Discharge (DC) record.