HOW TO BECOME A MEDICAID PROVIDER
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Provider participation in Louisiana Medicaid is entirely voluntary. State regulations and policy define certain standards for providers who choose to participate. These standards are listed as follows:
- Provider agreement and enrollment with the Bureau of Health Services Financing (BHSF) of the Department of Health and Hospitals (DHH);
- Agreement to charge no more for services to eligible recipients than is charged on the average for similar services to others;
- Agreement to accept as payment in full the amounts established by the BHSF and refusal to seek additional payment from the recipient for any unpaid portion of a bill, except in cases of Spend-Down Medically Needy recipients; a recipient may be billed for services which have been determined as non-covered or exceeding a limitation set by the Medicaid Program. Patients are also responsible for all services rendered after eligibility has ended;
- Agreement to maintain medical records (as are necessary) and any information regarding payments claimed by the provider for furnishing services, and;
NOTE: Records must be retained for a period of five (5) years and be furnished, as requested, to the BHSF, its authorized representative, representatives of the DHH, or the state Attorney General's Medicaid Fraud Control Unit.
- Agreement that all services to and materials for recipients of public assistance be in compliance with Title VI of the 1964 Civil Rights Act, Section 504 of the Act of 1978, and, where applicable, Title VII of the 1964 Civil Rights Act.