Billing procedures

(a) Claims from providers shall be submitted on the department's designated form or electronically transmitted to the department's fiscal agent and shall include all information required by the department to process the claim for payment. (b) The amount billed to the department shall represent the provider's usual and customary charge for the services delivered. (c) When a client is referred to a provider for consultation, the consultant provider shall include the referring practitioner's name. (d) When billing for anesthesia services, anesthesiologists shall include the name of the primary surgeon on the bill. (e) Laboratory services performed in the provider's office shall be payable to the provider and shall be billed as separate line items. When a provider refers a client to a private laboratory for services, the laboratory shall bill directly and no laboratory charge shall be paid to the provider. (f) when services are provided by more than one member of a group, the authorization request shall be submitted prior to billing as described in the billing instructions in the provider manual.