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Effective: December 1, 2006 |
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24.15.05ar1 - Verification of Health Care Expenses (Archive) |
Archived: January 1, 2010 |
Health Care Expenses Verification Requirements.
Health Care Expenses Verification Requirements
Verify all health care expenses if they are:
l Incurred during the application month or a retroactive month of coverage. These can be paid or unpaid health care expenses.
l Incurred prior to the certification period if they are unpaid.
To verify health care expenses either:
l Contact the provider directly.
l Request the client to provide copies of the bills.
Note: If the bills provided are not from the current billing cycle, contact the provider to verify that the amount of the bill is still accurate.
For each health care expense verify:
l The date of service.
l The full cost of the service and the amount remaining to be paid.
Note: Do not include finance charges or late fees in the total cost of the service.
l The exact amounts paid by the client or third parties.
l Any insurance or other third party payments.
l Any insurance or other third party denials.
Unverified health care expenses cannot be used to meet a spenddown.
Exception: MinnesotaCare inpatient hospital expenses for which the client cannot provide verification of costs may be used to meet a spenddown.
l Do not delay acting on the MA application if you cannot verify inpatient hospital expenses.
l For details on how to calculate the spenddown using this type of health care expense see the following sections:
n MinnesotaCare Expenses Used to Meet Spenddown.
n P bills.
n Applications.