R6-6-1304. Monitoring and Compliance

The Division shall monitor third-party payments made to service providers. The Division shall determine whether a service provider is in compliance with the requirements set forth in this Article by inspecting documents to assess: 1. Verifiability and reliability; 2. Appropriateness of recovery attempt; 3. Timeliness of billing; 4. Accounting for reimbursements; 5. Auditing of receipts; 6. Provision of claim and explanation of benefits to the Division; 7. Auditing of receipts; 8. Other monitoring which the Division deems reasonably necessary to ensure compliance.