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Procedures |
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The Crime Victims Compensation Program has established the following
to simplify and expedite the processing of your claims:
- All claims submitted should be on a HCFA 1500, UB04, or itemized
billing. An itemized billing must be
submitted for each patient. Do not combine patients on the same billing.
- Treatment records must be attached for each date of service. These can
be chart notes, session notes, treatment summary reports, or medical
records.
- Insurance explanation of benefits and all third party payment
information should be attached for each date of service. Insurance denials such as “duplicate” or “held pending receipt of a
questionnaire” are not acceptable.
- An Initial Treatment Plan must be completed by the
service provider before mental health benefits can be
processed. Initial Treatment Plans may also be required for
medication
management, physical therapy, chiropractic, massage therapy, and other
services as necessary to determine the compensability of a claim.
- For mental health claims, progress reports must be completed and submitted to the Program every
180 days, or as requested by the Program.
- A separate Family Assistance Application must be submitted for each
family member seeking counseling benefits. Only immediate family members
(parent, child or spouse of primary victim) of homicide, and sexual
assault victims are eligible for Family Assistance Benefits. An itemized billing and session notes for each date of service must be
submitted. Please note the name of the primary victim on the bill for
family assistance benefits.
Compliance with the above procedures will expedite payment of your claims. If
you have any questions, please feel free to contact the Claims Department at
(208) 334-6081.
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