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.
Examples of Billing validation in a sentence
Check Billing validation between the Switch and the Buyer's billing system.