Section 514.2 - Introduction.

514.2 Introduction. (a) The department has established an electronic eligibility verification system whereby a provider may determine the eligibility status of any person seeking care, services or supplies under the MA program before furnishing care, services or supplies to such person.

(b) The system was designed to assure that a provider can verify the current MA eligibility of persons seeking medical or dental care, services or supplies and, thus, be assured that legitimate claims submitted to the department for services rendered to eligible recipients will be paid.

(c) If, on the date of service, the provider verifies eligibility in accordance with the verification procedures of this Part, payment will not be denied because the recipient was not MA eligible on the date that the care, services or supplies were furnished.

 

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