Provider Responsibility. The Provider agrees, regardless of whether the Provider employs a ▇▇▇▇▇▇, to assume personal responsibility for, and ensure that: a. The county CHDP Office shall be sent a facsimile or an original CHDP claim for each CHDP visit, or the county CHDP Office shall be sent a printed source document that contains all of the CHDP claim data elements billed and/or reported to the CHDP program. b. The patient’s parent or guardian shall be given a facsimile or an original CHDP claim form for each CHDP visit, or the parent or guardian shall be given a printed source document that contains all of the CHDP claim data elements billed and/or reported to the CHDP program.
Appears in 2 contracts
Sources: Telecommunications Provider and Biller Agreement, Telecommunications Provider and Biller Application/Agreement