10A ncac 63G .0202       CLAIMS

(a)  Claims for services or supplies must be submitted no later than twelve months from the date of service.  The division shall not pay claims received more than 12 months from the date of service.

(b)  The amount reimbursed is payment in full.  The consumer shall not be billed for any unrealized balance except a co‑payment.  A co‑payment not to exceed five dollars ($5.00) may be charged the consumer by both the practitioner who provides the eye exam and follow-up and by the optical supplier.  This will reduce the division's liability by the amount of the co‑payment.


History Note:        Authority G.S. 111‑8; 143B‑157;

Eff. February 1, 1976;

Amended Eff. November 8, 1976;

Readopted Eff. November 16, 1977;

Amended Eff. August 1, 2002; February 1, 1986; June 1, 1983; June 1, 1978;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. November 23, 2015.