WAC 296-30-085   What is different about billing for a crime victim client?  (1) Providers must qualify as approved providers and register with the crime victims compensation program before they are authorized to provide treatment and receive payment. To register with the crime victims compensation program, you must send us:

     (a) A completed provider application and Form W-9.

     (b) A legible copy of your professional license, certification and/or registration.

     (c) Ph.D.s not licensed as psychologists and master level counselors must provide a legible copy of their degree.

     (2) Providers must determine if any public or private insurance benefits are available before billing the department. Available public or private insurance must be billed first and a copy of the insurance explanation of benefits must be attached to billings submitted to the department.

     (3) A client must not be billed for treatment of his or her accepted condition. All copayments, deductibles or out of pocket expenses not covered by primary insurance should be included in your billings to the department.

EXCEPTION:

A provider may require the client to pay for treatment if the client's eligibility is in question (e.g., when an investigation or claim determination is pending). If the claim is subsequently allowed, the provider must refund the client in full and bill us at their usual and customary fees if such rates are in excess of the public or private insurance entitlements.

     (4) On claims closed over ninety days, we will pay for completion of a reopening application, an office visit and diagnostic studies necessary to complete the application. No other benefits will be paid until the reopening decision is made. If the reopening application is approved, we can pay benefits for a period not to exceed sixty days prior to the date the reopening application was received by us.



[Statutory Authority: RCW 7.68.030, 7.68.080, 7.68.130. 00-03-056, § 296-30-085, filed 1/14/00, effective 2/14/00.]