When a woman does not have a medical provider to verify her pregnancy, take the following actions:
- Complete Verification of Pregnancy (Form 2304).
- Contact an approved Medicaid provider, and arrange for the woman to have a pregnancy test. The pregnancy may be verified by a doctor, clinic, social service agency such as Planned Parenthood or other qualified medical personnel.
- Explain to the provider that Medicaid will only pay for the office visit and the laboratory test to determine pregnancy. No other services can be authorized.
- Send Form 2304 to the medical provider along with a pre-addressed return envelope.
- Prepare an Invoice Voucher (Form C-13) when the provider returns Form 2304 along with a bill. The C-13 must contain the client's name, case address, and the statement "Administrative Expense for Pregnancy Test". See WAG 26-04-01 for instructions on completing a C-13.
- Send the completed C-13 and the provider's bill to the Bureau of Fiscal Operations.
- File Form 2304 in the case record as proof of the pregnancy.