Alabama Administrative Code
Title 560 - ALABAMA MEDICAID AGENCY
Chapter 560-X-38 - AMBULATORY SURGICAL CENTER SERVICES
Section 560-X-38-.09 - Billing And Sending Statement To Eligible Alabama Medicaid Recipients

Universal Citation: AL Admin Code R 560-X-38-.09

Current through Register Vol. 43, No. 02, November 27, 2024

(1) No eligible Alabama Medicaid recipient shall receive a bill or statement for covered services or items once the recipient has been accepted as a Medicaid patient. A recipient may be billed by the provider for noncovered services or items.

(2) The provider may send a notice to the recipient stating the recipient's claim is outstanding provided the notice indicates in bold letters: "THIS IS NOT A BILL."

(3) It is the responsibility of the provider to pursue any unpaid claim with the fiscal agent and/or Medicaid involving Medicaid covered services.

(4) No recipient is responsible for the difference between the covered charges billed and the amount paid by Medicaid for covered charges. A provider agrees to accept as payment in full the amount paid by Medicaid for covered services, and further agrees to make no additional charge(s) for covered services to the recipient, sponsor, or family of the recipient.

Author:

Statutory Authority: State Plan, Title XIX Social Security Act, 42 C.F.R. §§ 447.15, 447.50, 447.55.

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