Designated Provider Option
The next payment option is the designated provider option. This option allows clients to pay their obligation amount to a specific provider on a monthly basis, allowing other providers to have claims paid by MA. Some MA-LTC clients are required to use this option, while others have a choice.
In order to use the designated provider option the client must be willing to pay the recipient amount to the chosen provider at the time service is received. This allows the client to pay the same provider each month rather than paying different providers varying amounts based on the monthly EOMB. Those who choose to use this option must designate a provider who provides at least the spenddown amount in services each month. Before this payment option may begin voluntarily, both the enrollee and the designated medical provider must sign the Request for Designated Provider Agreement (DHS-3161).
When using the designated provider option the client is responsible to report a change in the medical provider 30 days before the change is made, so that a new designated provider may be chosen or to end this payment option.
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Obligation Payment Options