Section 181-40-005 - APPROVAL AND PAYMENTClaims may be approved for payment when all the following conditions are met:
(A) The client was eligible for participation in the Program when the service was provided and is currently approved;(B) The services provided are for covered services as described in 181 NAC 004;(C) The Provider has agreed to provide reports of findings and recommendations which are necessary to compile cancer surveillance data and reports to the funder, the Centers for Disease Control and Prevention. Additionally, the provider shall ensure that the program receives the required documentations specified in the Provider Manual as of the date of this regulation;(D) Invoice procedures outlined in the Provider Manual as of the effective date of this regulation are complied with; and(E) All other claims and documentations pursuant to the program policy as set out in the Provider Manual as of the date of this regulation, are submitted.005.01PAYOR OF LAST RESORT. The Program is a payer of last resort. Primary insurance providers must be invoiced first and have paid on a client's behalf before an invoice is sent to the program for payment by a provider.181 Neb. Admin. Code, ch. 40, § 005
Amended effective 6/14/2022