Section 464-1-016 - PAYMENTSThe Department determines whether payments are made directly to the recipient or to the provider.
016.01PAYMENTS TO THE RECIPIENT. Recipients receiving direct payment must complete a Department approved billing document. Incomplete or inaccurate billing documents will be rejected and not paid.016.02PAYMENTS TO THE PROVIDER. Providers receiving direct payment must complete a Department approved billing document. Incomplete or inaccurate billing documents will be rejected and not paid.016.03LIMITATIONS ON PAYMENTS. The recipient is responsible for any amount owed to the provider in excess of the authorized amount. The recipient must not bill the Department for more than the amount authorized. The Department will not pay recipient or the provider for any amount in excess of the authorized amount.016.04FREQUENCY OF PAYMENTS. Billing documents for respite services must be submitted no more than once a month per respite provider after all the respite services have been provided for the month. Billing documents must be submitted for any given month within 60 days of the date when the service is provided.016.05LACK OF BILLING WITHOUT JUSTIFICATION. The recipient may be determined Program ineligible if no claims have been submitted for Program authorized services for three consecutive months without providing justification to show how the recipient's needs were met during that time and why the needs will no longer be met without continued Program assistance.464 Neb. Admin. Code, ch. 1, § 016
Adopted effective 10/3/2021