PM 15-08-09-a: Spenddown Met - Single Expense

WAG 15-08-09-a.

When the client provides a single bill or receipt that meets or exceeds spenddown, the case is entitled to revised textmedical coverage effective from the day the expense was incurred through the last day of the same month.

If the bill is for a service provided in the month that the spenddown determination is being made, use the date of service as the spenddown met day. If the bill is for a service provided in an earlier month, consider the first day of the month the determination is being made, as the spenddown met day.

When a receipt is used to meet spenddown, always consider the receipt for the first day of the month that the determination is being made.