Ariz. Admin. Code § R9-25-1110 - Invoices (A.R.S. Sections 36-2234, 36-2239)

A. A certificate holder shall ensure that:

1. Each invoice for rates and charges contains the following:

1.a. The patient's name;

2.b. The certificate holder's name, address, and telephone number;

3.c. The date of service;

4.d. An itemized list of the rates and charges assessed;

5.e. The total monetary amount owed the certificate holder; and

6.f. The payment due date; and

B.2. Any subsequent invoice to the same patient for the same EMS or transport contains all the information in subsection (A) except the information in subsection (A)(1)(d).

C.B. A certificate holder may combine into one line item the charges for multiple items if:

1. the supplies are used together for a specific purpose, and

2. the name of the combined item is included in the certificate holder's list provided to the Department according to R9-25-1109.

D.C. A certificate holder may combine rates and charges into one line item if required by a third-party payor.

Notes

Ariz. Admin. Code § R9-25-1110

New Section adopted by final rulemaking at 7 A.A.R. 1098, effective February 13, 2001 (Supp. 01-1). Amended by final rulemaking at 30 A.A.R. 581, effective 3/7/2024.