048-8 Wyo. Code R. § 8-11

Current through April 27, 2019

Section 8-11 - Retroactive Eligibility

(a) A hospital may seek admission certification for a client found retroactively eligible for Medicaid benefits after the date of admission for services which require admission certification. An attending physician and a hospital shall not seek admission certification for a person whose application for Medicaid is pending at the time of admission.

(b) Procedure. The hospital shall request admission certification within thirty (30) calendar days after the hospital receives notice of eligibility. The request for certification shall be in writing and shall include the information required by Sections 9(b) and (c) of this Chapter. The request shall also include:

• (i) A statement of the date and method of notice of eligibility; and

• (ii) A copy of the clients complete medical record, submitted at the hospitals expense, which can be mailed or scanned to the Department.

(c) Failure to request certification in a timely manner or to submit the complete medical record with the request shall result in the denial of admission certification.

(d) The hospital shall inform the attending physician of the admission certification of a retroactively eligible client.

048-8 Wyo. Code R. § 8-11

Amended, Eff. 1/6/2015.