4123-7-07 Filing of bills.

(A) Fee bills for treatment subsequent to the initial care should be filed on a regular, periodic basis, such as once every four to eight weeks. Fee bills should not include services which were a part of a former fee bill. Duplicate bills should not be filed as a substitute for an inquiry, except upon notification from the bureau that there is no record of the original.

(B) In cases where treatment was not authorized in advance, the hearing officer, at the hearing, may, in the hearing officer’s discretion, determine that fee bills for such treatment are to be paid retroactively.

(C) The bureau does not pay for failed or missed appointments or procedures. Bills must only contain descriptions of services that have been actually rendered for the actual conditions treated. A provider shall not transmit to the bureau or self-insuring employer any bill containing false or misleading information that would cause a provider to receive payment for services that the provider is not entitled to receive.

R.C. 119.032 review dates: 10/27/2004 and 03/01/2009

Promulgated Under: 119.03

Statutory Authority: RC 4121.12, 4121.30, 4121.31, 4123.05

Rule Amplifies: RC 4121.121, 4121.44, 4121.441, 4123.66

Prior Effective Dates: 1/1/78, 1/15/99