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1,256 sections in this chapter.
R.23-306-1.3 Billing
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A. Providers must file a claim with the third party prior to billing Medicaid. Documentation of payment or denial must be submitted to the Division of Medicaid with the claim including but not limited to:1. The explanation of benefits (EOB), 2. Any amount paid by the third party,…
R.23-306-1.4 Casualty Cases
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A. In the event a provider has knowledge that an individual is a Medicaid beneficiary and is receiving or has received health care services which may be covered by Medicaid as a result of the accident or incident, the provider is prohibited from: 1. Demanding any payment from the…
R.23-306-1.5 Reimbursement
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A. The Division of Medicaid must be billed as the payor of last resort. B. Providers are required to file a claim with the third party prior to filing with the Division of Medicaid except in the following circumstances: 1. Preventive pediatric service, including EPSDT services, c…