Alabama Administrative Code
Title 560 - ALABAMA MEDICAID AGENCY
Chapter 560-X-7 - HOSPITALS
Section 560-X-7-.24 - Sending Bills And Statements To Medicaid Recipients

Universal Citation: AL Admin Code R 560-X-7-.24

Current through Register Vol. 42, No. 11, August 30, 2024

(1) Providers should not send recipients bills or statements for covered services once that recipient has been accepted as a Medicaid patient.

(2) Providers may send a notice to the recipient stating their claim is still outstanding if the notice indicates in bold letters: "THIS IS NOT A BILL."

(3) Providers are responsible for followup with the fiscal agent or Medicaid on any billing problems or unpaid claims.

(4) The Recipients are not responsible for the difference between charges billed and the amount paid by Medicaid for covered charges services.

(5) Providers agree to accept the amount paid by Medicaid as payment in full.

(6) Recipients may be billed only for the allowable copayment amount, for services not covered by Medicaid, or when benefits have been exhausted.

(7) Providers may not deny services to any eligible recipient due to the recipient's inability to pay the allowable copayment amount.

Author: Lynn Sharp, Associate Director, Policy Development Unit

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

Disclaimer: These regulations may not be the most recent version. Alabama may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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