Home Care Clinical Specialist – OASIS (HCS-O) Certification Practice Test

Which term is used when a patient's payer changes and a new start of care may be required?

Start of Care Visit Insurance Change Medicare Home Health Benefit Agency Policy

Correct Answer:

Insurance Change

Explanation:

When a patient’s payer changes, the formal term used is Insurance Change. This change may require initiating a new Start of Care to document the patient’s current status, ensure eligibility under the new payer, and establish a fresh plan of care that aligns with the new payer’s rules and billing requirements. The Start of Care Visit itself is the initial assessment that starts home health care, but the action described by the question—changing payers and potentially needing a new evaluation—falls under Insurance Change. The other options describe specific events or programs (the actual SOC event, the Medicare benefit, or internal policy) rather than the payer-change trigger itself.

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