PREREQUISITES FOR PAYMENT. Provided that there shall first have been a submission of claims in accordance with TRICARE procedures, the SUDRF shall be paid on the basis of the allowance of the rate determined in accordance with the controlling TRICARE regulation (see Article 4.1) contingent upon certain conditions provided in the TRICARE regulation, and in particular, the following: (a) The patient seeking admission is suffering from a mental disorder, to include SUD, that meets both the diagnostic criteria of the current edition of the DSM and the TRICARE definition of a mental disorder.
Appears in 8 contracts
Samples: Participation Agreement, Participation Agreement, Participation Agreement
