16 Del. Admin. Code § 4102-6.0

Current through Register Vol. 28, No. 7, January 1, 2025

Section 4102-6.0 - Billing and Reimbursement

6.1 A SBHC shall not charge co-pays or any other out-of-pocket fees for use of SBHC services.

6.2 The following services shall be exempt from third-party billing:

6.2.1 Any services provided to a student related to an evaluation or assessment of eligibility under the Individuals with Disabilities Education Act, 20 U.S.C. § 1400 et seq, or Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. § 701 et seq.; and

6.2.2 Any services provided to a student implementing an Individualized Education Program (IEP) or Section 504 Plan developed in conformity with either of the above federal laws.

6.3 Insurance information on each student in the SBHC must be updated annually at minimum.

6.4 Nothing in these Regulations is intended to prohibit or otherwise restrict a provider from billing for services for which it is authorized to bill under applicable state and federal laws and regulations, and that nothing in these Regulations is intended to create an independent basis for the denial of payment of any claim.

16 Del. Admin. Code § 4102-6.0

20 DE Reg. 980( 6/1/2017) (Final)