Ala. Admin. Code r. 560-X-38-.09

Current through Register Vol. 43, No. 1, October 31, 2024

Section 560-X-38-.09 - Billing And Sending Statement To Eligible Alabama Medicaid Recipients

(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:

Ala. Admin. Code r. 560-X-38-.09

Rule effective September 1, 1986.

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