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Providers are responsible for all stages of Medicaid claim transmission process, regardless of the method used to transmit claims and use of an intermediary
02/22/11
Providers are responsible for all stages of Medicaid claim transmission process, regardless of the method used to transmit claims and use of an intermediary
Healthcare providers should be aware that, regardless of the claim submission method, the provider bears full responsibility for all phases of the claim process. This includes the accurate, timely, and compliant submission of Medicaid claims and the monitoring of reimbursements, including timely disclosure and repayment of overpayments obtained from Medicaid.
The use of a billing service or clearinghouse does not absolve the provider of these responsibilities. Providers agree to these responsibilities by signing and filing an annual notarized claim certification statement, as required, for participation in the Medicaid system.
Providers must keep, for a period of six years from date of payment, records and information regarding a submitted claim and the related payment (if any), and must furnish this documentation upon request of the relevant agencies.
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