§ 33-21A-8. Participation by Dentists
Except as provided in subsection (b) of this Code section, no care management organization or agent of such care management organization shall deny any dentist from participating in the Medicaid and PeachCare for Kids dental program administered by such care management organization if: Such dentist has obtained a license to practice in this state and […]
§ 33-21A-9. Submission and Payment of Claims
If a provider submits a claim to a responsible health organization for services rendered within 72 hours after the provider verifies the eligibility of the patient with that responsible health organization, the responsible health organization shall reimburse the provider in an amount equal to the amount to which the provider would have been entitled if […]
§ 33-21A-10. New and Renewal Agreements With Care Management Organizations and Health Care Providers
On and after May 13, 2008, the Department of Community Health shall include provisions in all new or renewal agreements with a care management organization, which require the care management organization to comply with all provisions of this chapter. On and after May 13, 2008, a care management organization shall not include any provisions in […]
§ 33-21A-11. Hospital Statistical and Reimbursement Reports From Care Management Organizations; Penalty
Upon request by a hospital provider related to a specific fiscal year, a care management organization shall, within 30 days of the request, provide that hospital with an HS&R report for the requested fiscal year. Any care management organization which violates this Code section by not providing the requested report within 30 days shall be […]