55 Pa. Code § 4310.15
Current through Register Vol. 54, No. 50, December 14, 2024
If a third-party payment is received, the LLR/client is liable for that portion of the charges not covered by the payment up to their maximum liability. When a third-party payor makes direct payment to a LLR/client, the amount paid by the insurance company is payable to the provider in full in addition to the liability assessment against the client/LLR except when the imposition of client/LLR liability would exceed the monthly per diem rate for the facility.
55 Pa. Code § 4310.15