Ala. Admin. Code r. 560-X-48-.07

Current through Register Vol. 43, No. 1, October 31, 2024

Section 560-X-48-.07 - Billing Recipients

(1) A provider agrees to accept as payment in full the amount paid by Medicaid, plus any copayment amount required to be paid by the recipient for covered items, and further agrees to make no additional charge or charges for covered items to the recipient.

(2) Billing recipients for services not paid by Medicaid due to provider correctable errors on submitted claims or the untimely filing of claims is not permissible.

(3) A provider may bill the recipient for the copayment amount, for noncovered Medicaid services, and for services provided to a recipient who has exhausted his/her benefit limits.

Author: Vicki Huff

Ala. Admin. Code r. 560-X-48-.07

Emergency rule effective October 1, 1990. Permanent rule effective January 15, 1991.

Statutory Authority:42 C.F.R. §447.15; State Plan, Attachment 4.18-A; Title XIX, Social Security Act.