Applicable Fees. 9.3.1. CONTRACTOR shall not charge any clients or third-party payers any fee for service unless directed to do so by the Director at the time the client is referred for services. When directed to charge for services, CONTRACTOR shall use the uniform billing and collection guidelines prescribed by DHCS. 9.3.2. CONTRACTOR will perform eligibility and financial determinations, in accordance DHCS’ Uniform Method of Determining Ability to Pay (UMDAP), for all clients unless directed otherwise by the Director. 9.3.3. CONTRACTOR shall not submit a claim to, or demand or otherwise collect reimbursement from, the client or persons acting on behalf of the client for any specialty mental health or related administrative services provided under this Contract, except to collect other health insurance coverage, share of cost, and co-payments (Cal. Code Regs., tit. 9, §1810.365(c). 9.3.4. CONTRACTOR must not bill clients, for covered services, any amount greater than would be owed if COUNTY provided the services directly as per and otherwise not bill client as set forth in 42 C.F.R. § 438.106.
Appears in 7 contracts
Sources: Contract for Services, Contract for Services, Contract for Services
Applicable Fees. 9.3.159.1. CONTRACTOR shall not charge any clients or third-party payers any fee for service unless directed to do so by the Director at the time the client is referred for services. When directed to charge for services, CONTRACTOR shall use the uniform billing and collection guidelines prescribed by DHCS.
9.3.259.2. CONTRACTOR will perform eligibility and financial determinations, determinations for each beneficiary prior to rendering services in accordance DHCS’ Uniform Method of Determining Ability to Pay (UMDAP)with the Drug Medi-Cal Billing Manual, for all clients unless directed otherwise by the Director.
9.3.359.3. CONTRACTOR shall not submit a claim to, or demand or otherwise collect reimbursement from, the client or persons acting on behalf of the client for any specialty mental health SUD or related administrative services provided under this ContractAgreement, except to collect other health insurance coverage, share of cost, and co-payments (Cal. California Code Regs.of Regulations, tit. 9, §§ 1810.365(c)).
9.3.459.4. The CONTRACTOR must not bill clients, for covered services, any amount greater than would be owed if the COUNTY provided the services directly as per and otherwise not bill client as set forth in 42 C.F.R. § 438.106.
Appears in 3 contracts
Sources: Contract Amendment, Contract for Services, Contract for Services
Applicable Fees. 9.3.147.1. CONTRACTOR shall not charge any clients or third-party payers any fee for service unless directed to do so by the Director at the time the client is referred for services. When directed to charge for services, CONTRACTOR shall use the uniform billing and collection guidelines prescribed by DHCS.
9.3.247.2. CONTRACTOR will perform eligibility and financial determinations, in accordance DHCS’ Uniform Method of Determining Ability to Pay (UMDAP), for all clients unless directed otherwise by the Director.
9.3.347.3. CONTRACTOR shall not submit a claim to, or demand or otherwise collect reimbursement from, the client or persons acting on behalf of the client for any specialty mental health or related administrative services provided under this Contract, except to collect other health insurance coverage, share of cost, and co-payments (Cal. Code Regs., tit. 9, §1810.365(c).
9.3.447.4. CONTRACTOR must not bill clients, for covered services, any amount greater than would be owed if COUNTY provided the services directly as per and otherwise not bill client as set forth in 42 C.F.R. § 438.106.
Appears in 2 contracts
Sources: Contract for Services, Contract for Services