Ala. Admin. Code r. 560-X-6-.04

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

Section 560-X-6-.04 - Submission Of Claims: Routing Of Claims

(1) MEDICAID ELIGIBLES.

(a) Claims should be submitted to the fiscal agent in accordance with instructions for these patients who are enrolled for MEDICAID ONLY.

(b) Reimbursement for physicians' services will NOT be made to the patient, sponsor, or nursing facility. The Medicaid program does not provide for reimbursement of this expense to these individuals or facilities.

(2) MEDICARE ELIGIBLES.

(a) For Medicaid patients who are also enrolled for benefits under Part B, refer to Chapter 1 of this Code and the Alabama Medicaid Provider Manual.

Ala. Admin. Code r. 560-X-6-.04

Rule effective October 1, 1982. Amended effective May 9, 1984; March 12, 1987. Emergency rule effective February 1, 1989. Amended effective May 12, 1989. Amended: Filed February 7, 1994; effective March 15, 1994. Amended: Filed December 7, 1994; effective January 12, 1995.

Authors: Janet B. Young, Glen A. Smythe Statutory Authority: Title XIX, Social Security Act; 42 C.F.R. §§401, et seq.; State Plan.