Medicaid Billing Clause Samples
The Medicaid Billing clause outlines the procedures and requirements for submitting claims and receiving payment for services provided to Medicaid beneficiaries. It typically specifies the documentation needed, compliance with federal and state Medicaid regulations, and the timelines for billing and reimbursement. For example, it may require providers to use specific billing codes or submit claims electronically. The core function of this clause is to ensure that billing practices are consistent with Medicaid rules, thereby facilitating proper reimbursement and reducing the risk of denied claims or regulatory penalties.
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Medicaid Billing. The District will pay a fee of 4.95% of net revenues received by the District.
Medicaid Billing. The Charter School will cooperate in LCPS’ submission of billing documentation for all special education students who are Medicaid eligible in accordance with LCPS billing procedures. LCPS will retain the reimbursement. The Charter School will be required to maintain all Medicaid paperwork, if any, in the student’s cumulative folder for six (6) years. LCPS will ensure that Medicaid providers are credentialed in accordance with state regulations.
Medicaid Billing. If or to the extent that any Medicaid reimbursable services are provided to the Student, J ▇ ▇ ▇ ▇ ▇ ▇ ▇ ▇ C e n t r a l S c h o o l shall be solely and exclusively responsible for billing Medicaid for such services. Charlotte Valley staff that provides any Medicaid-reimbursable services to the Student shall timely prepare, maintain and submit to Jefferson Central School all documentation required for Medicaid billing, and shall fully comply with all applicable Medicaid billing required in providing services to the Student. Charlotte Valley will not ▇▇▇▇ Medicaid for any services rendered to the Student.
Medicaid Billing a. Medicaid earnings cannot be used as local match. In the absence of the Medicaid Electronic Verification report, the managing entity will rely on the subcontractors billing information.
b. Subject to the availability of the Medicaid Electronic Verification, the managing entity shall require that the Medicaid enrolled network providers will not bill the department for Medicaid billable services provided to Medicaid eligible recipients. FACT services for Medicaid clients can be billed to the department.
c. However, when services are covered under the Florida Medicaid program for Medicaid recipients and the recipient does not have other third party coverage, the department shall not be considered a liable third party for Mental Health and Substance Abuse Program payments funded through the department. Services shall then be billed to Medicaid and not the department;
Medicaid Billing. If or to the extent that any Medicaid reimbursable services are provided to the Student, Amsterdam shall be solely and exclusively responsible for billing Medicaid for such services. ▇▇▇▇▇-Fultonville staff that provides any Medicaid-reimbursable services to the Student shall timely prepare, maintain and submit to Amsterdam all documentation required for Medicaid billing, and shall fully comply with all applicable Medicaid billing required in providing services to the Student. ▇▇▇▇▇-Fultonville will not bill Medicaid for any services rendered to the Student.
Medicaid Billing. The CSB shall maximize billing and collecting Medicaid payments and other fees in all covered services to enable more efficient and effective use of the state and federal funds allocated to it.
Medicaid Billing. ACCESS Academy will cooperate in LCPS’ submission of billing documentation for all SPED students who are Medicaid eligible in accordance with LCPS billing procedures. LCPS will retain the reimbursement. ACCESS Academy will be required to maintain all Medicaid paperwork, if any, in the student’s cumulative folder for six years. LCPS will ensure that Medicaid providers are credentialed in accordance with state regulations.
Medicaid Billing. Bergen’s Promise will not be responsible for payment of Medicaid eligible services provided to Medicaid eligible recipients. This includes Providers of in-office therapy and residential services. Providers must ▇▇▇▇ Medicaid directly. Provider agrees to accept payments from Medicaid as defined by the Medicaid Fee Schedule as payment in full. Bergen’s Promise will not provide any additional reimbursement.
Medicaid Billing. The School District shall provide or arrange for the provision of all billing, collection and related accounting services required in connection with the provision of Consultant’s services hereunder. Consultant shall provide the School District with all information about services rendered in such form and substance as is required for School District to ▇▇▇▇ and collect for the services provided by Consultant hereunder. Consultant covenants and agrees that upon request of School District, Consultant will cooperate with School District and provide such additional information and documentation as may be reasonably requested by School District to allow School District to ▇▇▇▇ and collect for the services provided by Consultant hereunder.
Medicaid Billing. It is understood that all CSLs will bill Medicaid in accordance with OHA/ODE guidelines, district procedure and job descriptions.