WAG 20-04-01-c.
To bill HFS, providers must complete forms provided by HFS. To be paid, providers must submit bills within 12 months of providing the service. The 12-month time limit after providing the service also applies to resubmitting claims rejected by HFS.
Providers may submit their bills through Electronic Claims Processing (ECP) or in paper form.
NOTE: Bills can be submitted later than 12 months because of a court order or an appeal decision.
The provider's signature on the form confirms:
- the service was provided by the provider asking for payment;
- no payment or only partial payment has been received;
- the bill is the complete charge for the service; and
- the provider will not bill or accept payment from anyone else for the service, if the provider knew the client was eligible for medical benefits. This includes seeking additional payment from the client, except for any required copayment.
When a provider contacts the Family Community Resource Center about a billing question or problem, refer the provider to the appropriate provider manual.
