048-3 Wyo. Code R. § 3-8

Current through April 27, 2019
Section 3-8 - Verification of recipient data

(a) Identification Coupons. The Division issues Medicaid identification coupons to recipients. Such coupons are valid only for the month and year shown on the coupons.

(b) An individual who seeks services and does not have a valid Medicaid identification coupon is responsible for all charges for such services unless the provider receives written verification of eligibility from the Division or local agency before providing services. If a provider receives payment from an individual that is later determined to be eligible for Medicaid, the provider must refund any such payment to the individual before seeking Medicaid reimbursement.

(c) Failure to notify provider of eligibility. If a provider furnishes services to an individual who fails to notify the provider that he or she is a recipient, the provider may submit a claim to Medicaid or seek reimbursement or payment from the recipient. A provider which elects to seek Medicaid reimbursement must accept such payment as payment in full.

(d) Retroactive eligibility. A provider that furnishes services to an individual that becomes a recipient after the date of services may submit a claim to the Division seeking Medicaid reimbursement for services furnished during the period the individual was eligible for Medicaid. The provider may receive reimbursement as provided by the rules of the Department.

048-3 Wyo. Code R. § 3-8