This regulation governs billing and reimbursement procedures for Mental Health Rehabilitation Services (MHRS) providers contracting with DC's Department of Behavioral Health. Providers must submit claims through the Department's electronic billing system in accordance with their Human Care Agreement (HCA) and departmental billing policy. Providers must also maintain supporting documentation for all claims for a minimum of six years to support audits.
View official source5603 SUBMISSION OF CLAIM; PAYMENT OF VOUCHER 5603.1 In order for claims to be eligible for reimbursement, the MHRS provider shall: Submit claims through the Department’s electronic billing system pursuant to this chapter, the Department’s billing policy, and the terms of the HCA between the Department and the MHRS provider; and Complete appropriate documentation to support all claims under its HCA with the Department and shall retain such documentation for a minimum of six (6) years or longer if necessary to ensure the completion of any audit. 5603.2 The Department will reimburse an MHRS provider for a claim that is determined by the Department to be eligible for reimbursement pursuant to the terms of this chapter, applicable Department policies, and the HCA between the Department and the MHRS provider, subject to the availability of appropriated funds. SOURCE: Final Rulemaking published at 61 DCR 840 (January 31, 2014). District of Columbia Municipal Regulations Mental Health 22-A DCMR § 5603