N.H. Admin. Code § He-W 806.89

Current through Register No. 2, January 9, 2025
Section He-W 806.89 - Verification Requirements for In and Out Medically Needy Medical Assistance
(a) When requested to do so by the department in accordance with He-W 878.01, the client shall provide documentation of the following:
(1) Incurred current medical expenses and obligated prior medical debts, including those of individuals of a family, as defined in He-W 601.04(c) , or family members, as defined in He-W 601.04(f) , who reside in the same living unit as the client or for whom the client is liable;
(2) Medical services and amounts that are subject to third party reimbursement or insurance coverage; and
(3) The relationship between the client and the individual for whom medical expenses are claimed.
(b) Acceptable documentation of the above criteria shall include, but not be limited to:
(1) Provider bills, reminder notices and collection agency notices which are dated within 30 days of the month to which the debt is expected to be applied;
(2) A statement from the insurance company of the intent to pay covered charges, or the medical service provider's bill showing insurance payment;
(3) Department collateral verification by letter or telephone with the insurance or medical provider of the charges and allowances toward medical services;
(4) Historical data previously received by the department which documents the amount of the charges and allowances toward recurring medical services; and
(5) A birth certificate, baptismal record, marriage certificate, or other document that establishes the relationship between the client and the individual for whom medical expenses are claimed.

N.H. Admin. Code § He-W 806.89

See Revision Note #1 at Chapter heading for He-W 600) #5171, eff 6-26-91; ss by #5508, eff 12-1-92; ss by #6865, eff 10-3-98; ss by #8684, eff 7-21-06.
Amended byVolume XXXV Number 01, Filed January 8, 2015, Proposed by #10743, Effective 12/12/2014, Expires12/12/2024 (See Revision Note at Part heading for He-W 806).