Ala. Admin. Code r. 560-X-6-.16

Current through Register Vol. 42, No. 10, July 31, 2024

Section 560-X-6-.16 - Billing Of Medicaid Recipients By Providers

A provider may bill Medicaid recipients for the copay amount, for Medicaid noncovered services and for services provided to a recipient who has exhausted his/her yearly limitations. Conditional collections to be refunded post payment by Medicaid and partial charges for balance of Medicaid allowed reimbursement are not permissible. Billing recipient for services not paid by Medicaid due to provider correctable errors on claims submission or untimely filing is not permissible.

Author: Janet B. Young

Ala. Admin. Code r. 560-X-6-.16

Rule effective October 1, 1982. Amended effective July 9, 1984; June 8, 1985; March 12, 1987.

Statutory Authority: Title XIX, Social Security Act, 42 C.F.R. §§447.15, et seq.; State Plan.