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(a) An eligible provider must have a current provider agreement with the division. Application for a provider agreement may be made by writing the Division of Medical Assistance, Provider Enrollment, 4501 Business Park Boulevard, Suite 24, Anchorage, Alaska 99503-7167.
(b) Providing medical or medically-related services to recipients or billing the division for those services constitutes agreement by the provider
(1) to follow procedures that are consistent with guidance in the applicable Alaska Medicaid Provider Billing Manual as of July 14, 2000;
(2) to comply with applicable state and federal Medicaid law; and
(3) to cooperate in reports, surveys, reviews, or audits conducted by the department.
(c) The provider shall retain records necessary to disclose fully to the division the extent of services provided to recipients. Information regarding any payment must be made available, upon request, to division and federal personnel.
(d) A provider shall allow on-site inspection by authorized representatives of both state and federal agencies connected with the Medicaid program.
(e) The provider is responsible for claims submitted or certified by an authorized representative.
(f) The provider's or agent's endorsement of a check received from the division certifies that the claim for which the check is payment is true and accurate unless written notice of an error is sent by the provider to the division within 30 days after the date that the check is negotiated.
(g) In accordance with 7 AAC 43.950, a provider must refund to the division any reimbursed claim that the division finds, after a post-payment review, does not meet the requirements of this chapter.
(h) Providing medical or medically-related services to recipients or billing the division for those services constitutes an agreement by the provider that the division may take action under 7 AAC 43.081 to recover an overpayment.
History: Eff. 8/18/79, Register 71; am 5/5/93, Register 126; readopt 8/7/96, Register 139; am 11/29/97, Register 144; am 3/3/2001, Register 157
Authority: AS 47.05.010
Editor's note: Effective 8/7/96, Register 139, the Department of Health and Social Services readopted 7 AAC 43.065 in its entirety, without change, under AS 47.05 and AS 47.07. Executive Order No. 72 transferred certain rate-setting authority to the department.
The Alaska Medicaid Provider Billing Manual may be obtained by contacting the Department of Health and Social Services, Division of Medical Assistance, 4501 Business Park Boulevard, Suite 24, Anchorage, Alaska 99503-7167.
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Last modified 7/05/2006