Billing validation definition

Billing validation means pre-payment and other processes that are designed to ensure that the provider’s billing for waiver services meets essential tests and that only valid billings are included in the state’s claim for federal financial participation. The essential tests are: (a) the individual was eligible for the Medicaid waiver payment on the date of service; (b) the service billed was included in the participant’s approved service plan; and, (c) the services were provided. Billing validation is essential for ensuring the integrity of payments for Medicaid services.
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Examples of Billing validation in a sentence

  • Check Billing validation between the Switch and the Buyer's billing system.

Related to Billing validation

  • Toll Billing Exception Service (TBE) means a service that allows End Users to restrict third number billing or collect calls to their lines.

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  • Centralized Message Distribution System (CMDS) means the transport system that LECs use to exchange outcollect and Carrier Access Billing System “CABS” access messages among each other and other Parties connected to CMDS.

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