Or. Admin. Code § 333-010-0155

Current through Register Vol. 63, No. 11, November 1, 2024

Section 333-010-0155 - Payment

(1) The Center will make payment only to providers that have a medical services agreement with the ScreenWise BCC and are billing for an eligible client.

(2) The ScreenWise BCC reimbursement amount will be up to the Medicare reimbursement rate for the Portland metropolitan area for ScreenWise BCC approved CPT codes, on a fee-for-service basis.

(3) Federally qualified health centers or rural health centers are not paid at their Prospective Payment System (PPS) rate; they will receive up to the Medicare reimbursement rate for ScreenWise BCC approved CPT codes, on a fee-for-service basis.

(4) Center payments for ScreenWise BCC provider services, unless in error, constitute payment in full.

(5) The Center will not make payment on claims that have been assigned, sold, or otherwise transferred, or on which a provider of billing services receives a percentage of the amount billed or payment authorized. This includes, but is not limited to, transfer to a collection agency or individual who advances money to a provider for accounts receivable.

Or. Admin. Code § 333-010-0155

PH 9-2008, f. & cert. ef. 6-16-08; PH 13-2014(Temp), f. & cert. ef. 4-22-14 thru 10-19-14; PH 28-2014, f. & cert. ef. 10-10-14; PH 11-2016, f. & cert. ef. 4/1/2016

Stat. Auth.: ORS 413.042

Stats. Implemented: ORS 413.042