<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".05" citation="COMAR 10.01.10.05" title_num="10" subtitle_num="01" chapter_num="10" heading="Recovery and Reimbursement.">
  <paragraph num="A.">
    <text>If a client has insurance or if any other person is obligated, either legally or contractually, to pay for, or to reimburse the client for any service covered by this chapter, the medical provider shall seek payment from that source.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Payment. If payment is made by both the facility and insurance or other payer, the following conditions apply:</text>
    <paragraph num="(1)">
      <text>If the facility has paid all or part of the invoice and the third-party payer has made payment that represents payment in full, then the medical provider shall return the facility's entire payment to the facility;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>If the facility has paid the invoice in full and if the third-party payer has made payment that represents partial payment, then the medical provider shall return the amount of the third-party payment to the facility;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>If a third-party payer has made payment that is intended to be a partial payment and the facility has paid the remainder, then no repayment to the facility is required.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>The provider shall reimburse the facility for any overpayment.</text>
  </paragraph>
</regulation>