N.H. Admin. Code § He-C 6343.17
"I understand that provider billing requirements are governed by administrative rules (He-C 6339, He-C 6340, He-C 6348, He-C 6350, He-C 6914) which is incorporated herein by reference and I agree to abide by these requirements.";
"I understand and agree that as a provider, I am responsible for any and all billing invoices submitted by me or on my behalf by my authorized representative, whether user is an employee authorized as a billing representative or authorized billing representative of a management service company.";
"I understand and agree that any payments made which are based on inaccurate or fraudulent billing, whether submitted by me or by my authorized user will be recovered from me by DHHS.";
"I understand and agree that it is my responsibility to notify the Division for Children, Youth, and Families by contacting Provider Relations when a user no longer required access to the web billing application.";
"I understand that by submitting an invoice via the Provider Web Billing Application I am certifying that the invoice is true and accurate.";
"I understand and agree that information obtained via the Provider Web Billing Application is confidential and can be used solely for the purposes of administering Division for Children, Youth, and Families (DCYF) Services.";
"I understand and agree that I am responsible for my authorized representative, employee, and/or any management service company's use of the Provider Web Billing Application."; and
"I understand and agree that I must access my web account at least every ninety (90) days or my account will be de-activated.";
N.H. Admin. Code § He-C 6343.17
(See Revision Note at part heading for He-C 6343) #9390, eff 3-1-09