Regulation .07 Payment Procedures.

Payment procedures for this chapter are set forth in COMAR 10.09.36.

The Department will authorize payment on Medicare ambulance claims if:

(1)

The provider accepts Medicare assignments;

(2)

Medicare makes direct payment to the provider;

(3)

The services are covered by the Program;

(4)

Initial billing is made directly to Medicare according to Medicare guidelines;

(5)

Medicare has determined that services were medically justified.

The Department will make supplemental payment on Medicare ambulance claims, subject to the following conditions:

(1)

Deductible insurance will be paid in full;

(2)

Coinsurance will be paid in full.

Billing time limitations for claims submitted pursuant to this chapter are set forth in COMAR 10.09.36.