C.M.R. 10, 144, ch. 104, § 144-104-7, subsec. 144-104-7.08
Current through 2024-51, December 18, 2024
The following time limits apply unless waived under special circumstances by the Department. Providers have one (1) year from the date services are provided to file a claim correctly with the Department, regardless of when eligibility is verified.
Since it is the responsibility of providers to verify eligibility, members may not be billed for covered services that have been denied by the Department for exceeding this time limit for claims submission because the provider did not verify eligibility.
C.M.R. 10, 144, ch. 104, § 144-104-7, subsec. 144-104-7.08