Utah Admin. Code R414-525-2 - Medicaid Requirements

(1) A Medicaid interpretive service provider (ISP) shall submit invoices, via secure email, to the email address designated on the Department website.

(2) The service provider must use the invoice form prescribed by the Medicaid agency, and shall submit the form in its native file format.

(3) An ISP may only invoice Medicaid one time per month, except an ISP that submits both telephonic and in-person claims for payment shall submit two separate invoices, one for each type of service.

(4) An ISP shall submit an invoice no later than the last day of the month following the month the service is provided. For example, if a service were provided on April 20, the invoice would be due no later than May 31.

(5) The Department shall deny an invoice that does not meet the time requirement set forth in Subsection R414-525-2(4).

(6) An ISP may not bill for more than one Medicaid member per invoice line. An interpreter in a group situation shall divide the time appropriately and avoid overlapping time periods.

(7) The Department may recoup monies previously paid to an ISP for one year after the date of service, when the service is invoiced without a corresponding Medicaid claim in the state system. The Department, however, may not recoup monies when an ISP declares on the original invoice that a member missed a scheduled appointment.

(8) An ISP must conform to applicable Medicaid policies and procedures as well as other applicable laws.

(9) An ISP shall execute a business associate agreement with the Department before providing medical interpreting services that may result in a Medicaid claim.

Notes

Utah Admin. Code R414-525-2

Adopted by Utah State Bulletin Number 2020-19, effective 10/1/2020