Rule 23.15.404 - PROVIDER BILLING AND REIMBURSEMENT(1) To be eligible for reimbursement for the covered costs of the forensic rape examination, the medical provider must, within 90 days of performing the examination: (a) submit the FREPP claim form;(b) provide a copy of the patient information form;(c) provide an itemized statement of charges listing current procedural terminology (CPT) codes on a standard health care financing administration (HCFA) form; and(d) provide copies of all pertinent treatment records.(2) All billing paperwork should be mailed to the Office of Victim Services, ATTN: FREPP, P.O. Box 201410, 1712 9th Ave., Helena, MT 59620-1410.Mont. Admin. r. 23.15.404
NEW, 2005 MAR p. 2063, Eff. 10/28/05.46-15-411, MCA; IMP, 46-15-411, MCA;