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Rule Title: QUALIFIED MEDICARE BENEFICIARIES, BILLING
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Department: PUBLIC HEALTH AND HUMAN SERVICES, DEPARTMENT OF
Chapter: MEDICAID FOR CERTAIN MEDICARE BENEFICIARIES AND OTHERS
Subchapter: Requirements for Qualified Medicare Beneficiaries
 
Latest version of the adopted rule presented in Administrative Rules of Montana (ARM):

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37.83.830    QUALIFIED MEDICARE BENEFICIARIES, BILLING

(1) The requirements for billing medicaid are as follows:

(a) Claims for qualified medicare beneficiaries must be submitted to medicare first.

(i) Claims for medicare Part A insurance services must be submitted to the medicare Part A insurance intermediary for medicare payment and then submitted to medicaid on the appropriate claim form with the medicare explanation of medical benefits (EOMB) attached for payment of the deductibles and coinsurance.

(ii) Claims for medicare Part B insurance services must be submitted to the medicare Part B insurance carrier for medicare payment and then submitted to medicaid on the appropriate claim form with the medicare explanation of medical benefits (EOMB) attached for payment of the deductibles and coinsurance. The Part B carrier may, under an agreement with the department, submit the claims by electronic media to medicaid for payment of the deductibles and coinsurance.

History: Sec. 53-2-201 and 53-6-113, MCA; IMP, Sec. 53-6-101 and 53-6-131, MCA; NEW, 1989 MAR p. 835, Eff. 6/30/89; TRANS, from SRS, 2000 MAR p. 197.


 

 
MAR Notices Effective From Effective To History Notes
6/30/1989 Current History: Sec. 53-2-201 and 53-6-113, MCA; IMP, Sec. 53-6-101 and 53-6-131, MCA; NEW, 1989 MAR p. 835, Eff. 6/30/89; TRANS, from SRS, 2000 MAR p. 197.
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