Section 17b-262-743 - Billing procedure(a) Claims from providers shall be submitted on a hard copy invoice or electronically transmitted to the department or its agent in a form and in a manner specified by the department and shall include all information required by the department to process the claim for payment.(b) A claim submitted for an orthotic or prosthetic device that did not require prior authorization shall include the name of the licensed practitioner prescribing the device. A licensed practitioner's original prescription for the device shall be on file with the provider and shall be subject to review by the department.(c) Providers shall bill and the department shall pay at the lowest of: (1) the usual and customary charge;(2) the lowest Medicare rate;(3) the amount in the applicable fee schedule as published by the department;(4) the amount billed by the provider to the department; or(5) the amount the department indicates in writing in a prior authorization.Conn. Agencies Regs. § 17b-262-743
Adopted effective January 1, 2003