Idaho Admin. Code r. 16.03.09.918

Current through September 2, 2024
Section 16.03.09.918 - RECIPIENT EXPLANATION OF MEDICAID BENEFITS (REOMBS)
01.Monthly Surveys. The Department will conduct monthly surveys of services rendered to medical assistance participants using REOMBs.
02.Participant Response. A medical assistance participant is required to respond to the Department's explanation of medical benefits survey whenever they are aware of discrepancies.
03.Participant Unable to Respond. If the participant is unable, because of medical or physical limitations, to respond to the survey personally, then a responsible family member or friend can respond on their behalf.
04.Medicare-to-Medicaid Cross-Over Claims. All claims processed through the cross-over system will be subject to these rules. All providers submitting cross-over claims must comply with the terms of their provider agreements.

Idaho Admin. Code r. 16.03.09.918

Effective March 17, 2022