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
Amended byVolume XXXV Number 01, Filed January 8, 2015, Proposed by #10743, Effective 12/12/2014, Expires12/12/2024.