Sec. 10.02.03.03-1. Request for a Rate Review  


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  • A. If a recipient of services or other chargeable person submits a written request that the Division review the notice of rate establishment, the financial agent for the Division shall:

    (1) Review the notice of rate establishment to determine the accuracy of the charges established;

    (2) Review all pertinent information presented by the individual to determine if any adjustments in the billing are appropriate under these regulations;

    (3) Provide the individual with a final billing statement which indicates both the:

    (a) Division's position with regard to any written claims for a reduction in the rate established by the Division which are submitted by the individual to the financial agent; and

    (b) Final rates established by the Division for services rendered to a recipient of services.

    B. The recipient of services or chargeable person shall have such rights as are set forth in Regulation .05, of this chapter, to request an appeal hearing regarding the Division's informal rate review and the charges for services established by it. In order to note an appeal from the charges established pursuant to the informal rate review, the recipient of services or chargeable person shall follow the procedures as set forth in Regulation .05, of this chapter.