ARSD 67:16:26:07.02. Certain claims eligible for payment before third-party benefits recovered -- Department to pursue reimbursement

A provider is eligible to receive payment for the full amount allowed under the department's payment schedule while the department pursues reimbursement from third-party sources in the following situations: (1) The claim is for services for early and periodic screening, diagnosis, and treatment, provided under chapter 67:16:11, except for psychiatric inpatient services, nutritional therapy, nutritional supplements, and electrolyte replacements; (2) The third-party liability is derived from an absent parent whose obligation to pay support is being enforced by the department and 100 days from the date of service have elapsed; (3) The probable existence of third-party liability cannot be established at the time the claim is filed; (4) The claim is for nursing facility services reimbursed under chapter 67:16:04; or (5) The claim is for services provided by a school district under chapter 67:16:37.