Provider Reminder: Member Billing Guidelines

Date: 09/09/24

Heritage Health (Medicaid):

Nebraska Total Care is sharing, as a reminder for providers, the following information related to member balanced billing per NAC 471 3-002.11:

• Members are not to be balance billed for covered services or supplies
• A Network Provider’s failure to authorize the service(s) or not receive prior authorization due to failure to meet medical necessity does not allow the Network Provider to bill the member for service(s)
• Nebraska Total Care members cannot be billed for missed appointments (“No-Show”)

If you have questions, please contact Provider Relations.