Arizona Administrative Code
Title 6 - ECONOMIC SECURITY
Chapter 6 - DEPARTMENT OF ECONOMIC SECURITY - DEVELOPMENTAL DISABILITIES
Article 13 - COORDINATION OF BENEFITS; THIRD-PARTY PAYMENTS
Section R6-6-1303 - Collections of Health Insurance

Universal Citation: AZ Admin Code R 6-6-1303

Current through Register Vol. 30, No. 12, March 22, 2024

A. Service providers shall identify and pursue collections of reimbursement from all probable sources of third-party liability.

B. Service providers shall identify and notify the Division of any and all changes in health insurance information for clients.

C. The Division is the payor of last resort for DD/non-ALTCS Division-covered services, unless specifically prohibited by law. Service providers shall submit all claims covered by health insurance to the insurer prior to submitting a claim for payment to the Division.

D. When submitting a claim for payment to the Division, service providers shall include a copy of the explanation of benefits from the health insurer. The Division shall not pay for covered services if the client has insurance coverage which will pay for the service.

E. If a responsible person receives an insurance or benefit payment for a service provided through the Division, the amount received as payment is immediately due and payable to the Division. If the amount is not paid, the Division shall terminate eligibility.

Disclaimer: These regulations may not be the most recent version. Arizona 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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