10A NCAC 71J .0105. FUNDING FOR MEDICAL SERVICES

(a)  Title XIX (medicaid) shall be utilized as the first funding option for medical services.  County departments of social services electing to provide medical services as described in 10A NCAC 71R .0900 shall be responsible for the processing and payment of provider claims pursuant to those medical services authorized by the county.

(b)  If individuals have health insurance which will cover all or part of the bill for medical services, the amount allowed under Social Services Block Grant (Title XX) will be the difference between the insurance payment and the maximum amount which would be allowed at medicaid rates.  If the individual's insurance pays more than the allowable medicaid rate no funds will be available from Social Services Block Grant (Title XX).

(c)  Provider claims for authorized medical services must be filed within six months of the date of service.

 

History Note:        Authority G.S. 143B‑153;

Eff. June 1, 1982;

Amended Eff. July 1, 1990; July 1, 1984; July 1, 1982;

Temporary Amendment Eff. October 21, 1996;

Amended Eff. July 1, 1998.