<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".07" citation="COMAR 10.09.51.07" title_num="10" subtitle_num="09" chapter_num="51" heading="Payment Procedures.">
  <paragraph num="A.">
    <text>To obtain compensation from the Department for covered services, the provider shall submit a request for payment using the format designated by the Department.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Audiology services are reimbursed in accordance with COMAR 10.09.23.01-1.</text>
  </paragraph>
  <paragraph num="C.">
    <text>The provider shall be paid the lesser of:</text>
    <paragraph num="(1)">
      <text>The provider’s customary charge to the general public, unless the service is free to individuals not covered by Medicaid; or</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The rate in accordance with the Department’s fee schedule.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>The provider may not bill the Department or participant for:</text>
    <paragraph num="(1)">
      <text>Completion of forms and reports;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Broken or missed appointments; or</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Professional services rendered by mail or telephone.</text>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>Audiology centers licensed as a part of a hospital may charge for and be reimbursed according to rates approved by the Health Services Cost Review Commission (HSCRC), set forth in COMAR 10.37.03.</text>
  </paragraph>
  <paragraph num="F.">
    <text>The provider shall refund to the Department payment for hearing aids, supplies, or both, that have been returned to the manufacturer within the 30-day trial period.</text>
  </paragraph>
  <paragraph num="G.">
    <text>The provider shall give the Department the full advantage of any and all manufacturer’s warranties and trade-ins offered on hearing aids, equipment, or both.</text>
  </paragraph>
  <paragraph num="H.">
    <text>Unless preauthorization has been granted by the Department or its designee, the Department is not responsible for any reimbursement to a provider for any service provided which requires preauthorization.</text>
  </paragraph>
  <paragraph num="I.">
    <text>The Department may not make direct payment to participants.</text>
  </paragraph>
  <paragraph num="J.">
    <text>Billing time limitations for claims submitted pursuant to this chapter are set forth in COMAR 10.09.36.</text>
  </paragraph>
</regulation>