10A NCAC 43A .0205       THIRD PARTY REIMBURSEMENT PROCEDURES FOR LOCAL PROVIDERS

(a)  Local providers which have negotiated agreements for services to third party eligible persons shall adhere to an established set of medical service guidelines.

(b)  Budgeted amounts for Title XIX shall be based upon actual earnings during the previous year, carryover funds, as well as projected earnings during the current year.

(c)  Each local provider participating in any form of third party reimbursement shall budget all such funds into the program which earned the funds.  The Title XIX earnings shall be utilized to support the overall program.  Local providers shall have an accounts receivable system which complies with generally accepted accounting procedures.  Earned revenue that is budgeted and available to be disbursed shall be considered the first dollar spent.

History Note:        Authority G.S. 130A‑124;

Eff. February 1, 1976;

Readopted Eff. December 5, 1977;

Amended Eff. September 1, 1990; October 1, 1985; December 1, 1980.