Ala. Admin. Code r. 560-X-46-.07

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

Section 560-X-46-.07 - Billing Of Recipients

(1) No eligible Alabama Medicaid recipient is to receive a bill or statement for swing bed services once that recipient has been accepted as a Medicaid patient, except for the appropriate patient liability as described in Chapter 25.

(2) It is the responsibility of the provider to follow up with the fiscal agent and/or Medicaid, and not the recipient, on any problem or unpaid claim.

(3) A provider agrees to accept as payment in full the amount paid by the state, plus any patient liability amount to be paid by the recipient, for covered services, and further agrees to make no additional charge or charges for covered services to the recipient, sponsor, or family of the recipient.

(4) Providers may bill eligible recipients for noncovered services; i.e., private room accommodation charges incurred due to recipient's request, or personal comfort items requested by the recipient.

Author: Vicki Huff

Ala. Admin. Code r. 560-X-46-.07

Emergency rule effective March 30, 1989. Permanent rule effective July 13, 1989.

Statutory Authority: Title XIX, Social Security Act; State Plan, 3.1-A, 4.19-D; 42 C.F.R. §§447.15, 447.50, 447.55.